The Regulation of Pediatric Naturopathy and Recommendations for Improvement

• Author: Erin P. Ringel
• Position: J.D., Georgetown University Law Center (expected May 2023); B.A., University of Michigan (2020)
• Pages: 1095-1115

The Regulation of Pediatric Naturopathy and

Recommendations for Improvement

ERIN P. RINGEL*

INTRODUCTION

As naturopathy continues to expand in the United States,

1

issues surrounding its

availability and safety have arisen. This Note will focus on a subcategory of naturo-

pathic medicine, pediatric naturopathy, and argue that further regulation is necessary

in order to protect patients in this field of care. Part I will introduce pediatric natur-

opathy by discussing the history of naturopathy, its licensing requirements and avail-

ability, and its current principles. This part will also discuss the reasons why one

might opt for naturopathic care and explain how naturopathy has become part of pe-

diatric medicine with unique licensing requirements. Part II will explain how the

law currently regulates pediatric naturopathy in the areas of licensure, scope of prac-

tice, standard of care, and informed consent, and describe the law’s shortcomings.

This part will also discuss how problems with informed consent apply specifically

to pediatrics. Part III will propose recommendations for statutory reform in the areas

of licensure, scope of practice, informed consent, and legal consequences that should

follow from violating these statutes. These recommendations will be based on maxi-

mizing safety and increasing agency over medical care. This part will also explain

how lawyers have a unique obligation to help create this change. Finally, this Note

will conclude by restating that pediatric naturopathy is a field deserving of careful

regulation, given that children, especially adolescents who are capable of decision-

making, are not currently given appropriate agency over their medical decisions.

2

I. OERVIEW OF PEDIATRIC NATUROPATHY

A. NATUROPATHY

Naturopathy is a practice that “emphasizes use of the most natural, least inva-

sive remedies for treating illnesses.”

3

A key component of naturopathy is viewing

* J.D., Georgetown University Law Center (expected May 2023); B.A., University of Michigan (2020).

© 2022, Erin P. Ringel.

1. See Donald Patrick Albert & Ferry Butar Butar, Distribution, Concentration, and Health Care

Implications of Naturopathic Physicians in the United States, 9 COMPLEMENTARY HEALTH PRACTICE REV. 103,

104 (2004).

2. See Kimberly M. Mutcherson, Whose Body Is It Anyway? An Updated Model of Healthcare Decision-

Making Rights for Adolescents, 14 CORNELL J.L. & PUB. POL’Y 251, 259 (2005).

3. STACEY A. TOVINO & LUCINDA E. JESSON, COMPLEMENTARY AND ALTERNATIVE MEDICINE AND THE

LAW 14 (2010).

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the person holistically, which involves “considering all the factors that comprise a

person’s overall health, including a combination of genetics, environmental expo-

sures, lifestyle habits, diet, exercise history and social/emotional factors.”

4

NUHS Team, What is a Naturopathic Doctor and What Can They Do?, NAT’L UNIV. HEALTH SCI.,

https://blog.nuhs.edu/the-future-of-integrative-health/what-is-a-naturopathic-doctor-and-what-can-they-do

[https://perma.cc/D27N-6R32] (last visited Nov. 13, 2021).

The phi-

losophy of naturopathy can be traced back to ancient Greece.

5

Hippocrates, who is

known as “the founder of ancient Greek medicine,” approached medical treatment

in a way that is appreciably similar to modern naturopathy.

6

Hippocrates’s practice

“emphasized environmental causes and natural treatments of diseases, the causes

and therapeutic importance of psychological factors, nutrition and lifestyle, inde-

pendence of the mind, body, and spirit, and the need for harmony between the indi-

vidual and the social and natural environment.”

7

However, the actual term

“naturopathy” was devised in 1885 by Dr. John Scheel who practiced homeopathic

medicine.

8

Overview, OREGON ASS’N OF NATUROPATHIC PHYSICIANS, https://www.oanp.org/page/overview [https://

perma.cc/87B6-WWEP] (last visited Nov. 13, 2021).

Naturopathy began to develop in the United States during the early 1900s as

naturopathic schools were established, although the exact number of naturopaths

in the 1920s and 1930s is unknown.

9

Many chiropractors began incorporating na-

turopathy into their practices, and became known as “mixers.”

10

This resulted in

schools which offered Doctor of Naturopathy (N.D.) degrees and Doctor of

Chiropractic (D.C.) degrees.

11

From the 1940s to 1960s, states began restricting

the licensure and practice of naturopathic practitioners, resulting in only five

states providing licensure for naturopaths by 1958.

12

Finally, from the 1970s to

the 1990s, attitudes toward naturopathy began to shift as more naturopathic

schools of medicine were established, the American Association of Naturopathic

Physicians (AANP) was formed, and the AANP held its first convention in

1986.

13

Today, licensure is available in twenty-three states, the District of Columbia,

Puerto Rico, and the U.S. Virgin Islands.

14

Regulated States and Regulatory Authorities, AM. ASS’N OF NATUROPATHIC PHYSICIANS, https://

naturopathic.org/page/RegulatedStates# [https://perma.cc/Q2Z4-AGNY] (last visited Apr. 1, 2022).

The licensure process consists of

graduating from an accredited naturopathic medical program and passing the

4.

5. Christos F Kleisiaris, Chrisanthos Sfakianakis, & Ioanna V. Papathanasiou, Health Care Practices in

Ancient Greece: The Hippocratic Ideal, J. OF MED. ETHICS AND HISTORY OF MED., Mar. 15, 2014, at 2.

6. Id.

7. Id.

8.

9. Hans A. Baer, The Sociopolitical Status of U.S. Naturopathy at the Dawn of the 21st Century, 15(3) MED.

ANTHROPOLOGY Q. 329, 331 (2001).

10. Id.

11. Id. at 332.

12. Id. at 332.

13. Id. at 333–34.

14.

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