Chiropractic regulation in Italy: liability profiles in healthcare field

Chiropractic vertebral manipulation is indicated in patients with acute and uncomplicated low back pain. Nowadays, many people seek care for low back pain from manual practitioners. However, within the overall legislative framework regulating in Italy professionals practicing in healthcare, chiropractors remain unevenly regulated. In fact, they are trained abroad and hold internationally recognized degrees that are not regulated under Italian healthcare professionals' legislation. Neither the educational profile, nor a Ministry technical expert committee, nor a national board for ongoing professional evaluation has been established, despite a law in 2007 aimed to regulate the profession and define the national register of doctors in chiropractic. Meanwhile, given their involvement in the healthcare sphere as part of multiprofessional teams, issues of liability arise, made more complex by the fact that chiropractors are not eligible for certain more favourable legal measures for liability assessment granted to healthcare professionals under Italian Law on healthcare safety and liability. Moreover, health-related information for obtaining informed consent cannot be managed independently by these practitioners, again due to their non-healthcare professional status. As a result, prescribing physicians must necessarily be involved in the overall care process. The interaction between healthcare and non-healthcare professionals presents complexities in the patient care and in the proper liability assessment. These aspects are also urgently needed for the definitive recognition and valorisation of the practitioners working in health sphere, which must include State oversight.