Syndicat Professionnel des HomÃ©opathes du QuÃ©bec
The SPHQ or Syndicat Professionnel des HomÃ©opathes du QuÃ©bec, since its beginnings, has been a particular and unique organization, in the small, but international world of homeopathy. It started out in November 1989 as a professionnal union of homeopaths, affiliated to the Federation of Professionals (FP) which is part of the ConfÃ©dÃ©ration des Syndicats Nationaux (CSN), which represents more than three hundred thousand unionized workers in the province of Quebec, Canada. The primary spirit of linking the needs to organize, socialize and professionalize homeopaths dispersed and isolated in a huge territory with the growing needs of the population of Quebec (the same as Canada’s) for complementary and alternative care, has always guided the course of social, political and legal actions taken by the SPHQ.
The SPHQ has grown, self-regulated and integrated larger circles of homeopaths, like the former ICCH (International Council for Classical Homeopathy) and actual ICH (International Council for Homeopathy), where it has for a long while represented Canada, being the oldest and largest organized body of professional homeopaths in Canada since the end of the eighty’s.
Like other national homeopathic organizations, we have felt the wave of the denigration of homeopathy after ‘The Lancet affair’ and have not fallen. On the contrary, we have acknowledged the weaknesses and have taken up the challenge to and heighten academic and professional training. Through our means (i.e.. professionalization of homeopaths and integrated health approach and projects in Quebec, Canada and elsewhere) we seek social, political and institutional recognition and try to create opportunities for more formal legalization.
We share below our knowledge and understanding of the historical presence and comparative development of professional homeopathy in Canada and Quebec.
HOMEOPATHS IN CANADA AND IN QUEBEC
The Canadian provinces1 where homeopathic practice seems to be presently more concentrated are (no order intented) British-Columbia, Ontario and Quebec.
We do not have any recent data on the number of homeopaths in the country. Nevertheless, a survey done in 2001 assesses at 1200 the number of homeopaths members of professional associations, and about 500 students.2
1 The country is formed of 10 provinces and 3 territories, with 2 official languages, English and French, the later mostly concentrated in Quebec.
Provinces: British-Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, New-Brunswick, Nova-Scotia, Prince-Edward-Island, Newfoudland
Territories : Nunavut, Yukon, Northwest Territories
2 Fournier, Denis et A. Taillefer, EnquÃªte sur l’homÃ©opathie et les homÃ©opathes chez les organisations membres de la Coalition canadienne de mÃ©decine homÃ©opathique (CCMH), mai 2002.
Note : the CCMH doesn’t exist anymore.
Although two historical periods are considered in this document, we do emphasize the efforts taken in Quebec by the Syndicat professionnel des homÃ©opathes du QuÃ©bec (SPHQ) to provide a space for professional homeopaths in Quebec’s society.
Homeopathy arrived in Canada in the province of Ontario around the year 1840, and 2 years later in Quebec. We can definitely distinguish two historical periods for homeopathy in Canada.
THE FIRST PERIOD witnessed the establishment of homeopathy in Canada, its recognition, its practice within hospitals, its decline between the two great wars and its total absence from society. Both in Quebec and Ontario, this evolution and decline took a parallel path during this period.
How it took place in Quebec:
It is only in 1863 that homeopathy truly starts to structure itself in Quebec with the foundation of the MHA (The Montreal Homoeopathic Association) following a project of a community clinic for the poor of Montreal. The MHA will count on only 81 members in Quebec. In 1865, a law will recognize the homeopathic practice for the members of the MHA. In 1894, the «Montreal Homeopathic Hospital » is founded. It will be active until its vocation change in 1952, confirmed by its new designation. Thereafter, it was known as the «Queen Elizabeth Hospital», exclusively medical therefore. By the end of the 1960s, the creation of the Quebec Health Care regime and the creation of the «Office des Professions du QuÃ©bec» (Professions office) marks the end of homeopathy in Quebec, at least for this first period.
Homeopathy during this period was mainly practiced by English-speaking homeopathic doctors even in Quebec, even if the population was French-speaking in a large majority. There will be during this period only a few French-speaking homeopaths. The greater number of homeopaths had an American training.
THE SECOND PERIOD is the rebirth of homeopathy in Canada, of the creation of professional associations and the beginning of efforts to obtain legal recognition.
The situation in Quebec
Thanks to the support of French European homeopaths and laboratories, homeopathy makes a come back in Quebec in the late 1970s, early 1980s. Non-doctors homeopaths will mostly be trained and many different schools of thought will be found (complexist, pluralist, unicist).
1989 is the year where the Syndicat professionnel des homÃ©opathes du QuÃ©bec (SPHQ) will be created, bringing together the vast majority of homeopaths in Quebec. Its objectives are to improve the structure of homeopathic practice in the province, on an academic and a professional level, aim for legal recognition and establish a means to protect the public. To reach these objectives, the SPHQ endows itself with a Charter of rules (Statuts et RÃ¨glements), a deontological code (Code de dÃ©ontologie), training standards, a disciplinary committee, training and admission boards as well as a scientific board, which aims to promote homeopathic research and development.
DIFFERENT LEGAL SITUATIONS IN QUEBEC AND CANADA
Apart from Ontario, no legal recognition exists for homeopaths in Canada. In the majority of the Canadian provinces, there is no law concerning homeopathy, except in Manitoba, where medical law recognizes its exercise by conventional doctors.
The federal government establishes law on health issues for the whole population and the provincial and territorial government act locally for their own population. Thus the federal level deals with regulation concerning food and drugs, dangerous products, inspection etc. The provincial and territorial levels of government have the responsibility to safeguard health locally: hospitals, healthcare supervision, healthcare programs, professional regulations and control, as well as public healthcare matters.
Hence, it is not possible to draw a uniform picture of the legal situation of homeopathy in Canada, since each province has jurisdiction on professional practice and power to create (or not) a profession. To this situation can be added the prohibition to practice homeopathy in one province (Quebec), according to the ethical code of the provincial medical profession.
Since June 2007, the Ontario province, recognizes homeopathy as a profession under College of Homeopaths of Ontario and restricts the title of homeopath to members of the College. The «Homeopathy Act» does not however allow homeopaths to perform restricted medical acts, which are the trademark of other health professionals in Ontario, namely conventional doctors. A transitional board, soon to be appointed, will see to the proper structuring of the homeopathic profession in Ontario. For more information on the «Homeopathy Act»:
The medical law does not recognize the homeopathic profession. In the 1990s, when the legal situation of homeopathy was imprecise, a judicial confrontation took place on the matter in a model-case opposing the SPHQ to the Medical College of Quebec (CollÃ¨ge des mÃ©decins du QuÃ©bec -CMQ). Although the ruling does not question the competence of the homeopath concerned by the model-case, the legal exercise of homeopathy was restricted to the sole members of the CMQ. The reason put forward was that homeopathic doctors are active in Quebec to offer their services to the population. Yet, they are very few and the deontological code of the CMQ prohibits the practice of homeopathy to its members. The population’s needs for homeopathic care is then fulfilled almost exclusively by non-doctor homeopaths in private practice, most of them members of the SPHQ.
You will find in appendix 1 of this document a list of the main actions carried out, up until this day, by the SPHQ to obtain the recognition of the homeopathic profession in Quebec.
Presently in Quebec, a special governmental office, l’Office des professions, regulates the creation of a new profession only if its practice can cause serious and long term prejudice to someone, has autonomy of field (rather than specific acts) and thus, cannot be integrated into an existing professional practice. Homeopathic practice, sharing the large field of health and disease, and unable to prove serious health damage, has not been able, so far, to match these legal demands.
PROSPECTIVES FOR CANADA AND QUEBEC
At the SPHQ, we have been questioned, perhaps even criticized, about what seems to be a separate trail for the recognition of professional homeopaths in Quebec, from elsewhere in Canada or North America. To understand what is common and can be shared, but also what is very specific and has to be respected in our different paths towards the same goal – professional homeopathy throughout Canada and Americas- we must look, not so much at the differences of language and culture (French for Quebec, English for the rest of Canada), but at the fundamental opposition between the conception and application of two very different legal systems governing Quebec (the Napoleon Code) and the rest of Canada (the Common Law). The reader must always keep in mind that in Quebec:
The spirit of the Code Napoleon stipulates that ‘anything not allowed expressively is forbidden’; Applied to the world of health, the spirit of the Medical Law indicates that the entire field of health and disease (rather than specific acts), all preventive, curative, palliative care, is reserved to the professional MD’s of Quebec, unless specified by law.
In all other provinces of Canada, the legal frame is at opposites, specifying that:
a) Unless considered dangerous, or illegal specifically, freedom of action is preserved
b) Applied to health acts, specific acts are regulated and reserved for specific professionals; otherwise, tolerance founds the legal attitude.
The evolution of the situation of homeopaths in Canada follows different paths, and for the purpose of this document, we have circumscribed those which we were able to best describe. Since the enforcement of the new Canadian regulation on natural and health products on January 1st 2004, including homeopathic remedies, the situation of homeopathy in Canada evolves at a greater pace. In Ontario, a first provincial legislation recognizes the homeopathic profession in that province, by defining its acts and limits, according to Common Law. We consider this could serve as an example for other provinces in English-speaking Canada in near future, Quebec being again an exception. Effectively, in Quebec, both the medical law and the laws of the governmental Office des professions would have to change, in order for the professional homeopaths of the province to obtain a legal kind of College. On the other hand, the SPHQ is working on legal advice to eventually go back to the Supreme Court of Canada, to demand standardization of access to professional but non medical practice of homeopathy for the population of Quebec.
Finally, there will certainly be a very positive impact of this Ontarian recognition on specific insurance refund for homeopathic acts throughout Canada (so far limited to naturopathic prescriptions).
There is no university level program in homeopathy recognised in Canada, nor any education program substantiated by the provinces. All homeopathic trainings are presently offered by private colleges and/or schools.
The learning program established by the SPHQ since 1992 is the one the homeopathic schools are following in Quebec. It consists of 1500 hours of class attendance, of which 1035 hours are devoted specifically to homeopathy. The remaining hours are devoted to medical study (anatomy, physiology, pathology) and complementary courses. The SPHQ also offers an annual program of continuous training for its members, also open to non-member homeopaths. These are courses aimed for the graduate, the professional practitioners.
Since 2006, the SPHQ works alongside the UniversitÃ© du QuÃ©bec Ã MontrÃ©al (UQAM) on the establishment of a university program in homeopathy, in the context of a new integrated healthcare program. It would consist of a five year program, combining a undergraduate program in integrated healthcare to a graduate program in homeopathy, naturopathy or osteopathy, according to the chosen discipline. The novelty of this program is the partnership between the University and the private schools for the practical part of the program, in each discipline. Collaborating in the elaboration of this project alongside the SPHQ and UQAM are two other alternative health associations, namely the Association des Naturopathes AgrÃ©Ã©s du QuÃ©bec (ANAQ) and the Registre des OstÃ©opathes du QuÃ©bec (ROQ) . This university level program will be based upon the competence profile elaborated by experts at the UniversitÃ© du QuÃ©bec Ã Trois-RiviÃ¨res (UQTR), which will determine the dimensions of homeopathic practice, its specific acts and required level of proficiency. This university teaching profile could serve to establish national standards of homeopathic practice recognized at a university level, with all the peer recognition implied, as well as the access to loans and scholarships, essential to recruit young students in homeopathy.
Here is a list of the main documents produced for the SPHQ and available at the administration office:
1. Aubry, C., CalvÃ© C. et D. Fournier, Les homÃ©opathes dÃ©jÃ Ã l’Å“uvre dans la santÃ© publique quÃ©bÃ©coise, MÃ©moire prÃ©sentÃ© dans le cadre des travaux de la Commission d’Ã©tude sur les services de santÃ© et les services sociaux, September 2000.
2. Fournier Denis, A. Taillefer et coll., Les homÃ©opathes du QuÃ©bec. Sur la nÃ©cessitÃ© de leur reconnaissance professionnelle, 2002.
3. Fournier Denis et A. Taillefer, TÃ©moignages des homÃ©opathes et de leur clientÃ¨le sur une Ã©valuation qualitative du traitement mÃ©dical officiel et homÃ©opathique, 2003.
4. Taillefer, Anne et D. Fournier, Une politique d’Ã©thique sur la recherche en homÃ©opathie. Oser penser autrement, June 2004.
In collaboration with the SPHQ :
1. Cloutier, AndrÃ© et Gilles Dubois, Ã‰laboration d’un profil de compÃ©tences pour les HomÃ©opathes du QuÃ©bec, UniversitÃ© du QuÃ©bec Ã Trois-RiviÃ¨res (UQTR), May 2003
IN CANADA :
Funds for homeopathic research in Canada
A meeting was organized in January 2005 by the Natural Health Products Directorate (Direction des Produits de SantÃ© Naturels) of Health Canada, setting the priorities of research in homeopathy in Canada, meeting which the SPHQ attended. Following up upon this meeting, a research organism devoted to homeopathy has recently been created in the region of Toronto (Ontario): Homeonet. The first meeting of the advisory board of Homeonet in Toronto, where the SPHQ was invited, took place on February 15th 2008. Its first objective is to promote quality research in homeopathy in Canada. Homeonet offers funds to homeopathic associations throughout Canada for research projects in homeopathy.
The type of research favoured by Homeonet are the following :
Research that shows therapeutic efficiency vs remedy efficiency
Comparative and qualitative research aimed at vulnerable populations
Research establishing an integrated approach to other forms of therapies
Research on priority illness affecting public health, showing not only efficiency of homeopathy, but its relevance and economical advantage.
For more information, please visit the website of Homeonet :
IN QUÃ‰BEC :
Through the creation of HomÃ©opathes de Terre Sans FrontiÃ¨res (HTSF), an organization of sustainable development in community-based homeopathy, in partnership with Terre Sans FrontiÃ¨res (TSF), a Canadian organization of international cooperation supported by the Canadian International Development Agency, the SPHQ manages the professional participation of homeopaths in missions, seed-projects and research projects of the HTSF.
Hence, the SPHQ is engaged, through HTSF, in a research project: action against the Chagas disease, a blood-parasite disease which strikes Central and South America, yet slowly climbs up north (through transplacental transmission). Among other things, two homeopathic nosodes of the Trypanosoma Cruzi (one of them new), were created in partnership with an expert parasitologist of McGill University (Montreal). They served both for prophylactic and care in the region of Chagas, Honduras. For more information:
The SPHQ has also established agreement in clinical research with public health authorities in Cuba. The SPHQ is part of the scientific board of director for the next international symposium on homeopathic nosodes, in December 2008, organized by the Finlay Institute, in Cuba.
Finally, to our knowledge, the SPHQ is the first professional association of homeopaths to have endowed itself with an «Ethics policy on research in homeopathy» (Politique d’Ã©thique sur la recherche en homÃ©opathie), with a scientific board and a research ethic board.
See appendix 2
In Canada, as in Quebec, the non-conventional medicines are growing in importance. In Canada, in 1999, a study conducted by Ramsay et al., estimated that 73% of Canadians are using these practices. The same study revealed the following demands: an insatisfaction towards non-integrated healthcare, the risks of conventional treatments, research for more global care, more prevention, more focus on improvement of the quality of life, mainly for the chronically ill, a willingness to use all options available and to participate more in decision concerning health issues. These were the requests of Canadians and Quebecers alike. The demand is there and growing.
Meanwhile, the Canadian professional associations are getting better organized. The legal recognition of the professional practice of homeopathy in Ontario will most certainly have a speeding effect on the same recognition throughout Canada, at least for the provinces under the Common Law tradition.
In Quebec, the legal frame will be longer to obtain. The SPHQ may attempt anew to get to the Supreme Court of Canada, to gain the free access to professional homeopaths across Canada.
Through its roots of a workers-union organization, related to a public social institution, the SPHQ has developed a strategy of social and political recognition based upon the relevance of an homeopathic practice conceived as a “professional service” (rather than a trade), meeting the real needs of the population in public health care and put forward in a perspective of integrated health care for the ongoing development of the healthcare system in Quebec and Canada. Initial university training, continuous clinical training, development of reflexive practice and research competencies, participation to clinical pilot-projects, publications, promotion of inter-professional projects in an integrated healthcare perspective, development of partnership and common goals (national standards, national examination, insurance, research) with neighbor organizations, whether provincial or national, whenever possible, international networking: theses are the strategies for professional recognition of homeopaths presently led by the SPHQ in Quebec.
Fournier, Denis, Ã‰volution historique de la pensÃ©e homÃ©opathique, 1992.
Fournier, Denis et A. Taillefer, EnquÃªte sur l’homÃ©opathie et les homÃ©opathes chez les organisations membres de la Coalition canadienne de mÃ©decine homÃ©opathique (CCMH), mai 2002.
Website on the history of homeopathy:
Website of the Syndicat professionnel des homÃ©opathes du QuÃ©bec (SPHQ) www.sphq.org
Website of the Ontario government for the 2007 bill on homeopathy
Website of Health Canada (SantÃ© Canada)
Website of HomÃ©opathes de Terre sans frontiÃ¨res (HTSF)
Website of the research network HomeoNet
Main action of the SPHQ (FP-CSN) for the recognition of homeopathy and the profession of homeopath in Quebec
Since 1990 : representation in front of the ministÃ¨re de la SantÃ© et des Services sociaux (Healthcare department), du Conseil des Ã‰tudes supÃ©rieures et de la Technologie (council for higher studies and technology), de la Direction lÃ©gislative de l’AssemblÃ©e nationale (the legislative board of the National assembly), du MinistÃ¨re de la Justice (Justice department), de la RÃ©gie de la SantÃ© et des Services sociaux rÃ©gionaux (regional office of healthcare and social services) , de la Corporation professionnelle des mÃ©decins du QuÃ©bec (the medical board), de la Doyenne de l’UQTR (the UQTR dean) , etc.
The SPHQ was a member of the Bureau fÃ©dÃ©ral des mÃ©decines alternatives (BFMA- federal office for alternative medicine) of the CSN and so associated with osteopaths and naturopath in there actions for legal recognition. It is also a member of the Regroupement quÃ©bÃ©cois d’action pour la santÃ© des femmes (Quebec’s action group for women health) as welle as of the Conseil des approches alternatives et complÃ©mentaires en santÃ© (council for alternative and complementary approach in healthcare)
1990 to 1995 : Beginning of the participation of the SPHQ on the offical documentation on homeopathy that is preparing the Bureau des mÃ©dicaments en vente libre/SantÃ© Canada (office of freesale drugs, Health Canada). This participation will last until 1995, upon which the elaboration of regulation on natural product by a permanent committee of the federal Parliement.
1992 (Decembre) to 1998 : Model-case opposing the Medical Board of Quebec to the SPHQ, which was heard in provincial court, superior court, appeal court. The Supreme court of Canada however refused to hear the case. deposit
1993 : Official request of professional corporation at the Office des professions.
1993: Presentation of a dissertation at the Commission parlementaire sur les mÃ©decines alternatives (Parliament commission on alternative medicines)
1995 : Diverse manifestations of homeopaths and SPHQ : a petition with 10,000 names was presented to the government of Quebec asking :« the legalisation of the practice of homeopathy in Quebec by non-doctor homeopaths».
1995 : Actions to insert alternative medicines in university level programs. Request in parliamentary commission for a private bill -bill 205- in order to create an Academic Council which would have as main objective to overlook organisation and training of ostopaths, naturopaths and homeopaths.
1995 Ã 1998 : International symposiums held in Quebec
1996 : Admission of the SPHQ within the International Council for Classical Homeopathy (ICCH presently ICH), the most important group of non-doctor homeopaths in the world
1996 : Involvement in the elaboration of the regulation on natural products and dissertation on homeopathic products presented (1998) to Health Canada on this regulation
1997 : Participation to the Homeopathy Awareness Week
1998 : Meeting with the Senior Dean of the undergraduate studies of the UQTR, to consider an academic program for homeopathy, and others.
1998 : Dissertation presented by the SPHQ at the Parliamentary Commission on Health (Volpe Commission) on natural health products.
1998 : Request by the FP-CSN, to the Health minister and the president of the professions office of Quebec, of a document entitled: « Pour une vÃ©ritable reconnaissance des mÃ©decines alternatives » (For a genuine recognition of alternatives medicines) asking the government to create a Professional College for homeopaths
1998 : Press release of the FP-CSN asking the government to guarantee the public safety by creating Professional Colleges for homeopaths, naturopaths and osteopaths.
1999 to 2002 : Meetings with the successions of changing health department delegates to sensitize them to the importance of guaranteeing the safety of the public and proposing to work with the government on the best mean to organise the alternative approach to health.
1999 : SPHQ Symposium restating the priority to be known first by the people in order to get legal recognition of the profession of homeopath in Quebec
2000 : Dissertation presented to the ongoing Commission d’Ã©tude sur les services de santÃ© et les services sociaux (CESSSS) by the SPHQ : « Les homÃ©opathes : dÃ©jÃ Ã l’Å“uvre dans la santÃ© publique quÃ©bÃ©coise » (Homeopaths already at work for Quebec’s public health)
2002 (February) : La FÃ©dÃ©ration des professionnÃ¨les (CSN) – to which is associated the SPHQ -suggest a « Commission des thÃ©rapeutes alternatifs » (CTA), in answer to the Bernier Report. This CTA will see to the temporary organisation and public information. It will also recommend to the Professions office ways to organise legally and integrate alternative practitioners. Following up on this proposition of a CTA, the SPHQ edited a document entitled: « Les homÃ©opathes du QuÃ©bec. Sur la nÃ©cessitÃ© de leur reconnaissance professionnelle ». (Homeopaths in Quebec. The necessity of professional recognition)
2002-2003 : SPHQ delegation send to the workshop of the Natural Health Product Directorate (DPSN), in order to set up the regulation specific to homeopathy in the Regulations of natural health products. The contribution of expert from the SPHQ was indeed crucial because it was those delegates which found a way to remove homeopathic remedies from the laws and regulations that govern conventional medication.
2003 : Production of a document intitled: « TÃ©moignages des homÃ©opathes et de leur clientÃ¨le sur une Ã©valuation qualitative du traitement mÃ©dical officiel et homÃ©opathique » (Testomonials of homeopaths and their patients on a qualitative evaluation of the official and homeopathic medical treatment). It is the first survey ever done on the work of homeopaths in Quebec and the efficiency of their approach.
2003 : Conclusion of the framework established by the UQTR expert on the competence profile of homeopath. This framework forms the basis on which the SPHQ claims an university degree training.
2004 : Policy of research in homeopathy, outlining the orientation all research in homeopathy in Quebec must follow, in order to offer the public a quality homeopathy which meets the international standards and preserve the integrity of homeopathy.
2004 : Entry into effectiveness of the new regulation on Natural health product (DPSN), which recognises and officially organises homeopathic remedies in Canada, aiming to ascertain its security, quality and efficiency has a natural health product.
2005 : Birth of HomÃ©opathes de Terre Sans FrontiÃ¨res (HTSF), result of a partnership between Terre Sans FrontiÃ¨res (NGO working for sustainable development of undermined populations in underdeveloped countries) and the SPHQ. HTSF’s objective is to initiate and support homeopathic mission all around the globe, in order to offer the most deprived and those without access natural health care in a sustainable development context.
2006 : Start of the collaboration with UQAM on the elaboration of an future academic program in integrated health care.
2006 to 2008 : Participation to the World Homeopathy Awareness Week (WHAW), in hope to make known to the public the efficiency of homeopathy in Quebec and worldwide when it is exercised by well-trained professionals.
2008 : Submission of a dissertation (throughout the FP) at the Castonguay Commission on the integration of alternative and complementary medicine within Quebec Healthcare system, in order to, among other things, reduce the cost of the healthcare system.
2008 : Organisation of an Interprofessional Symposium entitled: «Perspectives in integrated Health Care; Then and now, homeopaths fighting against epidemics» which will take place on May 30, 31st and June 1st 2008. This symposium is aimed toward homeopaths and other healthcare professionals which intervene at different level in the healthcare field.
Here are Canadian homeopathic association for which information can be found on the Internet. The list may be incomplete.
OHA (1992) Ontario Homeopathic Association
1043 Bloor Street West, Suite 205, Toronto (Ontario) M6H 1M4
[email protected] www.ontariohomeopath.com
CSH (2000) Canadian Society of Homeopaths
101-1001 West Broadway, Unit 120, Vancouver (BC) V6H 4E4
[email protected] www.csoh.ca
BCSH BC Society of Homeopaths (BCSH) in British Columbia www.bcsh.ca
HMCC Homeopathic Medical Council of Canada (Association mÃ©dicale)
31 Adelaide Street East, Box 605, Toronto (Ontario) M5C 2J8