Here's the site in question: http://www.diabetes-warrior.net/2012/01/28/this-site-free-speech-are-being-investigated/
Some guy with diabetes finds low-carb paleo, loses weight, goes off insulin, and decides to preach about it online. He gives advice to people on how to follow in his footsteps.
Then he goes to a meeting of North Carolina nutritionists and apparently pisses them off. They are now investigating his website to see if they can hit him with a misdemeanor charge of giving nutrition advice without a license. According to their claims, giving any nutritional advice without a license is illegal.
So here we are on Paleohacks, handing out nutritional advice left and right. Are we violating North Carolina state law? Should Patrik put in a hack that prefaces every single post with "I'm not a doctor... "?
(trying to avoid the obvious political justification side of this discussion)
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Let's see them go after Michelle Obama first.
It's absurd to think advice and opinions aren't protected speech. Only if a person tries to commit willful fraud or harm to another would it be an issue.
I am not a doctor...but I am a lawyer, and those of you that have touched on the passing yourself off as a medical professional are mostly right. It comes down to whether someone can reasonably rely on your opinion. You can reasonably rely on the opinion of a doctor for medical advice, you can't reasonably rely on a homeless person for the same, and by that, hold them to the same standard of care. I won't bore you with the details (unless you want them) but it's more about the difference between someone wholly relying on your answer vs. knowing you're not a doctor etc and following your advice anyway.
For the purposes of PH, I wouldn't lose a ton of sleep over it. You could put a disclaimer at the bottom of the post which would cover you (this isn't medical advice etc), or a click wrap that said I agree in submitted this I understand it is not for the purposes of receiving medical advice (there are a lot of options here). Also just for the record, "I never said I was a doctor," is not a defense, if a reasonable person could infer that you are.
It's a complicated issue, but I guess that's why law school is such a bitch.
Oh, and I live in North Carolina :) and this was not legal advice, just general ramblings about general things ;)
I think that where he got into trouble was in references on his site to diabetes and managing diabetes. Because diabetes is a specific illness, it could, possibly, be construed as "diagnosing and treating".
I have friends who are involved in alternative health. They have to be VERY careful. Most of them call themselves 'consultants', and only accept "clients". They don't "prescribe" -- diets, supplements, etc. -- they "recommend". And they're VERY VERY clear from day 1 and at every meeting that they're consulting, not diagnosing or prescribing, and that the folk who come to them aren't patients with diseases... they're clients with challenges.
I think that if he'd made sure that the disclaimers were very very clear, and provided "food plans" rather than "diabetic diets", he might have been ok... however, the thing that is MOST telling about this is that someone at that meeting took the effort and energy to look him up and turn him in.
I've had a lot of people suggest that it is better to "change the Behemouth from the inside". I disagree. I think that once you're inside the belly of the beast, you're as likely to get chewed up, digested, and poo-ed back out as you are to make any lasting change... especially when 99% of what is inside is going to be fighting you all the way to maintain the status quo. I think the only way we CAN effect change is from the outside, and the best way to go about it is to continue telling our stories, and hope like heck that people slowly get the message.
I studied to become a nutritionist up in Canada (btw I think the original poster is confusing 'nutritionist' with 'dietician', as nutritionists are NOT licensed, either). We got a LOT of education/emphasis regarding what we were legally allowed to tell people or NOT tell people. We can't "treat" people in terms of any medical conditions they have; we can't diagnose (obviously, and I don't disagree with that), and we have to word everything in some kind of ambiguous, non-diagnosing, non-illness-centered language. ie. "I can't tell you anything I recommend will help disease X, but I can recommend things that will improve your nutrition status." Or something like that. It's rather ridiculous, but nobody wants a lawsuit or whatever other legal ramifications there may be brought against them. Tbh I am surprised at some of the paleo sites I visit and podcasts I listen to, because it really does sound like these people (whom I trust more than most doctors!) are treating specific medical conditions with the advice they give out. Maybe the U.S. has different laws regarding what you can say in a medical/disease context than what Canada has, or maybe the laws regarding that stuff just aren't enforced on every single person testing them. And I'm glad that people are willing to share their wisdom/experiences regarding how to achieve better health because if they didn't we'd all be stuck with CW.
I always understood the standard being: you can only give illegal advice if you pass yourself off as a qualified, licensed professional.
I read the NC law posted in the link. I believe this can be fought. I am not a lawyer, this is only my opinion. The crux of it all depends on whether the OP blogger can be considered as "practicing" in order to provide "service" to a "consumer". Its a blog not a business, he is not providing a service but rather opinions, and has no consumers but rather visitors.
Even when referring to "diabetics" as a group in his website, I suspect the meaning of "group" in the law (as in assessing/determining needs of individual or group) refers to an explicitly defined group of specific (i.e. named) individuals for collective engagement. Otherwise, "humanity" also qualifies as a group to the ridiculous extreme.
The trick is, to make sure anything on the website can survive a court battle, as I have not reviewed all of the bloggers web site information myself in order to provide (a neither legal nor professional) opinion.
I am not a doctor...
And please do not read this if you are in North Carolina...
Honestly I do think there is a fine line between relating our own experience and giving advice, that we would do well not to cross.
. X worked for me
. Have you tried x? are always better than...
. You should do X.
The bigger issue for me is that in a lot of countries/states, you have to sign up to certain CW concepts like "heart-healthy" slow release whole grain carbs are good for you, in order to become certified. If this were not the case, it wouldn't be left up to "renegades" like us to put the real science out there and challenge CW.
As long as you are not pretending/passing yourself off as a medic/doctor or qualified nutritional adviser, I am not sure there is much the authorities can do.
The authorities are pissed that their 'authority' is being ignored and flatly contradicted - resulting in apparently superior outcomes. Thus they are having to do a bit of sabre rattling.
If you go to a gym you'll get dietary advice and nutritionists have never targetted PTs in my experience!
Also, consider the dietary advice from Kelloggs with regard to their food brands. They issue dietary advice on packaging as well as websites - little of it is truly 'bespoke'.
Well to say the least, Paleohacks is a global community, and so the jurisdiction for us is highly ambiguous.
Within America you're supposed to have your First Amendment, no? Or can North Carolina mothers not tell their children how to eat without breaking the law?
It's actually very simple. If you say something that is detrimental to someone who has a lot of money who could make them lose a lot of money, then you will be pursued. It's the American way!
As long as you don't pass yourself as acting in a professional capacity, then I don't think anybody could win a case against you. That however doesn't mean that can't bring a case against you and make your life hell and totally screw you up with legal fees and crap like that.
Probably wouldn't hurt to have some sort of disclaimer at the bottom of every page. Something along the lines of what's at the end of the Everyday Paleo podcast.
I totally get the outrage here, but this issue has been weighing on my mind.
All of us bloggers and otherwise Paleo broadcasters do share a responsibility. I'm guessing disclaimers will become quite common on sites like PH and others. Maybe my blog.
I realized this when I started blogging and some of my friends who gave it a shot weren't having the results I did. And it occurred to me that I wasn't interested in being anyone's guru, especially when there are folks like Chris Kresser, Mark Sisson, Whole9, and Robb Wolf doing it far better than I ever could. But I still want to be out there sharing information and discussing topics of interest, and I think that line can get pretty fine.
And besides, if you were at a conference of peers and some hack started participating who didn't have the proper credentials to talk about your profession, wouldn't you be pissed too?
But all that being said, I'm glad those nutritionists got a comeuppance. Took serious cojones, I salute you, sir.
I recently interviewed Steve Cooksey, the blogger investigated by the NCBDN for Paleo Magazine. If you'd like to check out his take on the situation, you can check it out here...http://www.paleomagonline.com/2012/05/04/interview-with-steve-cooksey/
This kind of sums it up though:
"At this point, where do things stand? On the NCBD website, they posted that they had withdrawn their complaint. http://www.ncbdn.org/file_a_complaint/recent_press_inquiry/
Essentially, they are saying that I am in compliance with state law and that they have withdrawn the original complaint. In my opinion, the state has restricted my free speech. I can???t say, ???You are diabetic and I think you should eat less than 30 grams of carbs per day until your blood sugar is normalized.??? I???m not allowed to say that. Now, your doctor is most likely not going to say that, your diabetes educator is not going to say that, somebody needs to say that."
I think a factor in this case is that the guy was offering paid consultations to individuals.
If you read his summary of what went on, one issue is that he offered to help people on a one on one basis, paid, to help achieve what he did. That could be construed as offering paid solutions for medical problems, something the board would (and should) look into. Sharing anecdotal evidence should be free speech. Giving medical advice, especially for profit (however little - he did say for nominal charge), is regulated.
Providing opinions over studies, in the way Taubes does, is perfectly normal and protected, it is similar to the discussion portion of a metastudy. If he claims it will cure cancer and sell you the secret, he better be licensed.
Its the same in the pharmacy world. A tech can know all the answers, but if they get caught giving "professional opinion", rather than factual answers, it is grounds for dismissal. Professional opinion is reserved for pharmacists.
Sorry to be annoying and add another response, but does anyone think the era of the internet is changing the rules?
I mean, a court already decided that a blogger is not a journalist and not subject to those protections under the law.
So how, then, do we hold people responsible for advice given over the intertubes? I mean, it's not like people aren't actually trying this stuff out. Exhibit A = Paleo Hacks. :) How do we differentiate between "experts" and hacks?
I was at a party recently, and someone asked about the food thing (again!), so I responded and of course, someone listening asked me if I had a degree in nutrition or anything. After I got done grinding my teeth, I said, No, I didn't, but as a writer and someone who's interested in the topic, it benefits me to carve a niche for myself. Taubes did the same thing and it's paid off quite well for him. A degree does not (necessarily) an expert make. Grr. But I guess I could potentially be as much a part of the problem as the solution, since the dissemination of information is precisely part of the SAD and CW issues we see.
Wow, sorry folks. That's the LAST time I post after a latte. (P.S. - That's probably a lie.)
This whole topic ticks me off when thinking about the rubbish the big names tout on their websites, in their books, on the tv programs with the like of Dr Oz; Dr Dean Odell; "alternative doctor" Dr Weil who continue to over look the inflammatory properties of the whole grains & legumes they recommend to "lose weight" & "avoid coronary disease"...
I put my thoughts out on Steve's situation in a new post here:
I'm curious how doctors can give nutritional advice when they historically have no classes or training in nutrition. They don't have licenses to practice nutrition or dietetics any more than Steve.
As an update: do y'all realize he's now suing the state of NC? http://www.blueridgenow.com/article/20120531/APN/1205310692
As Cartman from South Park put it... "GODDAMN HIPPIES!!!"
If they are going to shut down on the basis of any online advice being a "practice", they have to shut down a lot more sites than just paleo ones, like the grapefruit diet and "HippieHolisticMedicine.com". But paleo is a target because it reveals the emperor (the medical community) has no clothes!
It should be noted that he was asked to comply and he did comply with their requests and the trouble is over. A month ago. Methinks hits are over 9000 with DW.
Yes!.. I mean No!
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if the guy went to the NC nutritionists' meeting and talked about how diabetic people should take insulin and keep eating grains (presumably the same advice as the nutritionists would give) - 1) he would still be giving out medical advice without a license, and 2) the nutritionists would not sue him over giving out those medical advice. people have a nasty habit of questioning ur sanity, legal standing, or character when u don't agree with them, especially in scenarios where u r right and they can't prove u r wrong (so they attack anything and anyway around the bush to destroy u and ur credibility).
my advice is free, if i was charging they might have a case. if i sold a book i might be profieting but the advice was free. so, i can assume i unles i send a bill my advice on this site is free also.
I give actual medical device, as I am a Dr' practicing in Zimbabwe. Try me.
Because we can soundly rely on the medical community's objectivity anymore, right?
I followed the links to NC's law and its from about 10 years before blogs. The law states that anyone distributing information is "practicing."
NC can't shut down the Internet, but they can try I guess. Nothing will come of it.
People should not worry about what they have been saying. No big deal.
This is a horrible news when it comes to know like this. The doctors suggesting us to have a 6hr deep sleep.
This is a kind of rest we want everyday. We should not put down this. Even the billing company like us(http://www.billingparadise.com) are meeting lot of medical claims in the name of sleeping problems and wrecks