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Review of CVMA General Position Statement
An open letter to the CVMA
By Task Force For Veterinary Science member, Moe Milstein, DVM
The following is a proposed position statement from the Canadian Veterinary Medical Association (CVMA) regarding CAVM. It resembles the wording in the recent AVMA model practice act discussed on this site and for which a letter campaign was activated. I have included my response to the CVMA as an attachement below.
TO: CVMA MEMBERS
FROM: CVMA DIRECTOR, PROGRAMS - ( firstname.lastname@example.org )
As a CVMA member, you are invited to comment on the 2 CVMA general position statements below before these are submitted to CVMA Council for approval. You can register your views on the Discussion Boards on the CVMA Web site which you can access by clicking www.canadianveterinarians.net or simply respond to this e-mail and we will post your comments on the Discussion Boards. We will conclude the discussions on April 18, 2003. The 2 position statements are as follows:
Alternative and Complementary Veterinary Medicine
The Canadian Veterinary Medical Association (CVMA) believes that the use of alternative and complementary medical therapies on animals constitutes the practice of veterinary medicine. The Association also holds that these
therapies should only be offered in the context of a valid veterinary / client / patient relationship and that informed client consent must be obtained. Clients should be informed of conventional diagnostic and therapeutic options
that are applicable and available. The CVMA also believes that it is incumbent upon veterinarians who use alternative and complementary therapies to become adequately trained in their application.
The CVMA recognizes that the use of alternative and complementary therapies may be beneficial in some situations but is concerned that sound clinical research which supports the use of these modalities in animals is lacking for many of the applications.
The CVMA encourages veterinarians who use alternative and complementary therapies to critically evaluate the risk and benefits of their selected treatments to ensure they are in the animals' best interest.
Alternative and complementary therapies in veterinary medicine are considered to include but are not limited to acupuncture and acutherapy, chiropractic, physical therapy, massage therapy, homeopathy, botanical medicine, bioenergetic medicine, aromatherapy and nutraceutical medicine.
"The Canadian Veterinary Medical Association (CVMA) maintains that for any homeopathic, natural, herbal, biologic, or "parabiologic" product to be approved as a veterinary drug or biologic, the manufacturer must provide
substantive data proving efficacy of action, freedom from adverse side-effects on the animal, and freedom from residues or potentially harmful contaminants."
All substances defined as drugs to be administered to animals must have a curative or corrective purpose. In the interest of public safety, any product used as a drug or biologic in food production must not only be safe and
efficacious, but used in a manner to ensure that there are no residues in the meat.
PLEASE NOTE: To access the "Members Only" section of the CVMA Web site, you will log into the Veterinarians section using your personal CVMA ID number or personal password, and then click on Discussion Boards, then select National Issues and then the Position Statements in question. You can post your comments by clicking Reply to Subject.
Should you have any problems logging in, please reply to this e-mail by identifying yourself and providing a brief description of the error message.
Moe Milstein, DVM
Adoption of the position statement regarding alternative and complementary medicine (CAVM) would be a grave error that will embarrass the profession and reverse the progress we have made in the 20th century.
There is only one medicine or veterinary medicine--that which has been demonstrated to be of use in the treatment and diagnosis of animal health and disease by the most rigorous means of analysis available to science and logic. If any manipulation, treatment, diagnostic method, etc. has passed the test then it becomes part of the body of knowledge and the practice of what we call veterinary medicine. If it fails to do so, or is shown to be ineffective, then that given treatment, technique, or diagnostic method, is discarded and should not be given some special status which would allow it to be associated with the practice of veterinary medicine.
The distinction between veterinary medicine and CAVM is a false one. It is a false dichotomy that serves only those who seek advantage by the promotion of CAVM. Having failed to prove their claims through scientific means, they seek to accomplish their goals through political means. Adoption of this position will give undeserved credibilty to CAVM and will not serve the interests of the profession.
It is true that anything done to an animal constitutes the practice of veterinary medicine according to most veterinary acts. This protects the public from falling prey to unqualified people with improper training. It therefore goes without saying that any veterinarian who uses the techniques commonly considered as CAVM should be held to the same standards as any other vetrinarian without the need to create a separate CAVM category. Especially when that new category is held to a lower standard of proof.
The position statement says "The CVMA recognizes that the use of alternative and complementary therapies may be beneficial in some situations but is concerned that sound clinical research which supports the use of these modalities in animals is lacking in many of the applications." A careful review of the literature shows that, in spite of years of studies, there is no evidence that any of the modalities listed as CAVM have been of any discernible use. Furthermore, their theoretical underpinnings have also never been demonstrated and, in fact, they defy the laws of physics and chemistry in most cases. Following upon that conclusion, the notion of encouraging veterinarians to acquire training in one of these fields becomes nonsensical. Why does one need to be trained in a field which has never been shown to offer any therapeutic efficacy, is based on notions long since proved false by science or, conversely, has failed to prove itself by the standards of logical reasoning?
I would remind the CVMA that CAVM proponents also duistinguish themselves by claiming that they represent "non-evidenced based" medicine in contradistinction to the rest of veterinary medicine. To grant any credibility to CAVM, as this position statement does, is to endorse the validity of non-evidence based medicine. This would be a rejection of the entire history of medical progress and a reversion to the pre-scientific era and its superstitions and ignorance. How will the CVMA assure itself that veterinarians will "critically evaluate the risk and benefits of their selected treatments..." when the whole concept of proof is rejected by CAVM.
I urge the CVMA not to accept this position statement. On the contrary, I think it is time the CVMA stood by the hard won gains made by the profession in the latter half of the 20th century, and issued a statement that the promotion of modalities which have not been proven to be effective or have been shown by reasonable examination to be ineffective will bring the profession into disrepute and as such constitute malpractice.
Moses Milstein B.Sc., DVM
North Vancouver, BC