An appeal board says no action should be taken against a Toronto doctor who provides an unproven and risky treatment to children with autism.
The Health Professions Appeal and Review Board (HPARB) issued the decision last week after Anne Borden, a Toronto mother of a boy with autism, appealed an earlier decision by the College of Physicians and Surgeons of Ontario (CPSO). Ms. Borden had filed a complaint with the college against John Gannage, a doctor in Markham who provides chelation therapy to children with autism. A college committee determined that no action needed to be taken against Dr. Gannage, and Ms. Borden appealed the decision to the HPARB.
Chelation therapy involves injecting a synthetic solution into the bloodstream to remove heavy metals and is approved by Health Canada as a treatment for people with heavy-metal poisoning. Some people believe the false theory that autism is caused by heavy metals included in vaccines, and that chelation therapy can treat or cure it by removing heavy metals from the blood. According to a Cochrane review of evidence published in 2015, there is no evidence heavy metals play a role in autism and no proof chelation therapy works. But there are numerous reports of chelation therapy leading to serious injuries and even death, according to the review.
In 2005, a five-year-old British boy went into cardiac arrest and died after undergoing chelation therapy at a U.S. clinic. Britain’s National Health Service has included chelation therapy on its list of “fake and harmful autism ‘treatments.’ "
In its decision, the HPARB said the college was correct in deciding not to take any action against Dr. Gannage because there’s no evidence his use of chelation therapy directly resulted in injury or other harm to a child.
The decision states that Dr. Gannage appears to be in compliance with the college’s policies, which say patients have a right to pursue alternative treatments and that doctors shouldn’t be punished for providing them unless there is evidence the therapy is riskier than the traditional medical approach.
Tim Caulfield, Canada Research Chair in health law and policy at the University of Alberta, said the decision casts doubt on the ability of regulatory bodies governing doctors and other health professionals to properly police the use of non-evidence-based treatments that could pose risks to patients.
“That is their mandate. Not protecting their members, but protecting the public,” Mr. Caulfield said. “If they can’t act in this kind of situation, what is their role?”
Dr. Gannage declined an interview request to answer questions about the case.
In an e-mailed statement, the CPSO said it does not take a position on individual treatments or therapies. But the college said physicians must use sound clinical judgment, evidence and a risk-benefit analysis when offering complementary treatments. Physicians must also obtain informed consent, the statement said. The college is currently updating its policies on complementary and alternative medicine, which is expected to be finalized next year.
A spokeswoman for the HPARB declined an interview request, saying the board’s decision speaks for itself.
Ms. Borden said the health-care system should be able to protect the public, and children in particular, from treatments that don’t work.
“The regulatory system isn’t working,” Ms. Borden said. "You shouldn’t have to wait for someone to get really hurt or possibly die before you can take action on regulating something that shows clear evidence of harm and no evidence of benefit."
She said she decided to lodge the original complaint after hearing about the injections, supplements and other non-evidence-based treatments other parents were giving to their children with autism. Ms. Borden said she feels some health professionals manipulate families into believing that autism can be fixed or cured with alternative treatments.
“The CPSO, in my opinion, has abdicated their responsibility to those children," Ms. Borden said. “It’s their responsibility to protect the health and safety of children. They need to stop this being done to kids.”
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