Go directly to legislation of specific CAM therapies in Austria: Acupuncture - Anthroposophic medicine - Ayurveda - Chiropractic - Herbal medicine/Phytotherapy - Homeopathy - Massage - Naprapathy - Naturopathy - Neural therapy - Osteopathy - Traditional Chinese Medicine (TCM) - Other treatments
Austria became a member of the European Union(EU) in 1995 (11) and of the Council of Europe on 16 April 1956 (12).
The legal and regulatory status of CAM and CAM practices
We have found no specific CAM regulations in Austria. Physicians are, however, implicitly permitted to use alternative treatments (21).
The Bundesgesetz über die Gesundheit Österreich GmbH (GÖGG) (the Health Care Act Austria) (22) managed by Österreichisches Bundesinstitut für Gesundheitswesen (ÖBIIG) regulates the basic health system in Austria (22).
The Ärztegesetz BGBl, I Nr. 169/1998 (Law on physicians)(3) regulates the profession of medical doctors in Austria. The Physiotherapy Act regulates physiotherapy and occupational therapists BGB1. Nr. 460/1992 (23). Different medical massage professions are regulated by the BGBl. I Nr. 169/2002 (24). Midwives are subject to the “Hebammengesetz” BGB1. Nr. 310/1994 (25).
Medical practise is limited to medical doctors. The “Ärztegesetz”(Federal Medical Law) states that practicing as a medical doctor includes every task based on medical-scientific knowledge that is performed directly on a person or for the person (25). All doctors are mandatory members of a medical chamber in their respective province (Landesärztekammer) who jointly constitute the Austrian Medical Chamber (Österreichische Ärztekammer) (26). The “Österreichische Ärztekammer” manages the mandatory list of medical doctors (27).The Federal Medical Law states in section 1.2; “Only legally qualified and authorized professionals are allowed to practise medicine” (28). Medicine is defined in the Ärztegesetz as: “All activities based on medico-scientific knowledge carried out directly or indirectly on human beings” – “performed for the purposes of diagnosis, treatment, and prophylaxis” (§2,Ärztegesetz).
Many physicians in Austria have a diploma of at least one form of CAM. The training in CAM methods is located in the different scientific/medical CAM societies, which specialize in one of the CAM traditions, like homeopathy (Österreichische Gesellschaft für Homöopathische Medizin-ÖGHM), anthroposophic medicine (Gesellschaft für Anthroposophische Medizin in Österreich- GAMÖ) and others. CAM training courses require certain standards to be achieved before awarding an “Ärztekammerdiplom”. The diplomas are awarded by the Austrian Medical Board. The most common methods are acupuncture, anthroposophic medicine chiropractic manipulation, homeopathy, neural therapy and traditional Chinese medicine (29).
“A fundamental question is if the term “treatment” (“Heilverfahren”) is subject to legal reglementation. An explicit legal norm for treatment, in particular regarding osteopathy does not exist in Austria. Who and with which methods and concepts is permitted to “heal” respectively perform treatments on patients, can be gathered from the respective medical fields” (25).
Medical acts that are not provided by authorized health professionals, such as midwives, medical-technical assistants, and nurses, are reserved for physicians (Ärztegesetz (Law on Physicians) of 1984 (173,174) (28).
According to the Law on Health Services, only scientifically recognized medical care can be provided in hospitals. Acupuncture, neuraltherapy, and chiropractic are recognized, but not homeopathy (22).
The governmental supervision of CAM Practices
The ‘Gesundheitsreformgesetz’ (health care reform act) BGBL I No. 179/2004 regulates health quality in Austria (30).
The ‘Bundesinstitut für Qualität im Gesundheitswesen (BIQG)’ (The Federal Institute for Quality in the Health Care System (BIQG)) manages health quality coordination (31,32). BIQG is a unit of ‘Gesundheit Österreich GmbH’ (32). The legal basis for BIQG is ‘Das Gesundheitsqualitätsgesetz (GQG)’ (The Health Quality Act)(30) and the ‘Gesetz über die Gesundheit Österreich GmbH (GÖGG)’ (The Health Care Act Austria)(31).
“These actors include social security institutions, federal ministries, provinces, professional societies, chambers and professional representations, patient advocacies and patient support groups” (32). “The Austrian Society of Medical Quality Assurance and Quality Management LLC (ÖQMED), which is fully owned by the Austrian Medical Chamber, periodically publishes a Medical Quality Report in which the results of its evaluation of physician’s practices are given” (32).
Austrian doctors are answerable to courts of law and to their competent local disciplinary commission, which acts under the supervision of the disciplinary council of the Austrian Medical Chamber (26). Article 136 of the Austrian Ärztegesetz (Act on the medical profession) regulates breach of discipline (Disziplinarvergehen)(27). In the same way physiotherapy is regulated by article 33 “Strafbestimmungen in MTDGesetz” (23) and massage professions by article 78 “Strafbestimmungen in MMhm-Gesetz” (23).
The Criminal law; BGBl Nr. 60/1974 (33) draws the boundaries for appropriate conduct by medical professionals (26) (§ 80 and §110 in special)(33). Unskilled persons who practise medical acts or activities reserved for physicians, risk a fine or imprisonment of up to three months (Article 184 of the Penal Code). The court is tolerant, and the law is enforced only on practitioners that use methods with no scientific support (28).
The reimbursement status of CAM practices and medicinal products
For acupuncture a small reimbursement is provided by the social security services, if the indication is pain.
All other possible acupuncture indications are not reimbursed. Costs for CAM treatments in general are not reimbursed by social security services, but in special cases this is negotiable (cancer patients, children). Patients have to consider that themselves and negotiate reimbursements on their own initiative. Private insurance companies offer packages that include CAM.
3. Wiesener S, Falkenberg T, Hegyi G, Hök J, Roberti di Sarsina P, Fønnebø V. Delieverable 9 – Report No. 3 – CAM Regulations in EU/EFTA/EEA. In: Wiesener S, Fønnebø V, editors. CAMbrella project FP7-HEALTH-2009, GA No.241951; Work Package 2; Deliverable 9 – Legal status and regulation of CAM in Europe, 2012.
11. EUROPA. Gateway to the European Union; member countries. Brussels EUROPA
Communication department of the European Commission; 2011 [cited 2011 November 3]; Available from: http://europa.eu/about-eu/countries/index_en.htm.
12. Council of Europe. Council of Europe. Strasbourg: Council of Europe; 2011 [cited 2011
November 7]; Available from: http://www.coe.int/lportal/web/coe-portal.
21. Maddalena S. Alternative medicines: on the way towards integration?; A comparative legal analysis in Western countries. Bern: University of Neuchâtel School of Law and Economics, Peter Lang Pub, Inc; 2005. 648 p.
22. Bundesgesetz über die Gesundheit Österreich GmbH (GÖGG) 132/2006, Bundesrat Austria(2006).
23. Bundesgesetz über die Regelung der gehobenen medizinisch-technischen Dienste (MTDGesetz) (Physiotherapy Act) StF: BGBl. Nr. 460/1992 Bundesrat Austria(1992).
24. Bundesgesetz über die Berufe und die Ausbildungen zum medizinischen Masseur und zum Heilmasseur (Medizinischer Masseur- und Heilmasseurgesetz – MMHmG) StF: BGBl. I Nr. 169/2002, Bundestag Austria(2002).
25. Wilfling E. Survey, Systematisation and Comparison of Professional, Advanced and Continuing Training Programs for Osteopathy available in Austria in the Winter Term 2006/2007. Wien: Donau Universität Krems; 2007.
26. Bernhard A. Koch. Medical malpractice in Austria. Tort and insurance law. 2011. This paper is based upon a contribution to MEDICAL LIABILITY IN EUROPE. A COMPARISON OF SELECTED JURISDICTIONS (Bernhard A. Koch ed., 2011).
27. Ärtzegesetz 1998 (Act on the medical profession) Bundesgesetzblatt [BGBL] I No. 169/1998, as amended to 2008. Bundesgesetz vom 10. November 1998, Bundesrat Austria(1998).
28. ECH (European Committee for Homeopathy). ECH in European Countries. Brussels: ECH; 2011 [cited 2011 September 12]; Available from: http://www.homeopathyeurope.org/countries.
29. CAMbrella. CAMbrella news. Münich: CAMbrella; 2011 [cited 2011 November 03]; Available from: http://www.cambrella.eu/home.php?il=1&l=deu.
30. Auszug aus dem Gesundheitsreformgesetz 2005, BGBl. I Nr. 179/2004. Bundesgesetz zur Qualität von Gesundheitsleistungen (Gesundheitsqualitätsgesetz – GQG), Bundestag Austria(2004).
31. Gesundheit Österreich GmbH. Dem Bundesinstitut für Qualität im Gesundheitswesen (BIQG). 2012 [cited 2012 January 18]; Available from: http://www.goeg.at/de/BIQG-Aufgaben.html.
32. GmbH GÖ. The Austrian Health Care System; Key facts. Radetzkystrasse 2, 1030 Vienna, Austria: Österreichisches Bundesministerium für Gesundheit /Austrian Federal Ministry of Health; 2010 [cited 2010 January 18]; 1st edition, June 2010:[Available from: http://www.bmg.gv.at/cms/home/attachments/2/1/2/CH1015/CMS1287855495948/the_austrian_health_care_system_2010_e1.pdf.
33. Strafgesetzbuch (StGB) (Penal code) BGBL No. 60/1974, as amended, Bundestag Austria(1974).
173. Nuzzi R. Non Conventional Medicine in Italy. History, Problems, Prospects for Integration. Evidence-Based Complementary and Alternative Medicine. 2008;5(4):491-2.
174. The Italian Parliament. Law 244 of December 24, 2007, art.2, paragraph 355. 2007 [cited 2012 March 27]; Available from: http://www.chiropratica.it/legislazione/riconoscimento-dellachiropratica/