From homeopathy to shiatsu. The various attempts to use the law to circumvent science

In Parliament, alongside initiatives on homeopathy, two bills on shiatsu are currently pending. A.C. 1456 was tabled by Luciano Ciocchetti, a Member of Parliament for Fratelli d’Italia; A.C. 2742 by Luana Zanella, a Member of Parliament for Alleanza Verdi e Sinistra. There is therefore consensus across the government and the opposition. The issue is not the professional recognition of practitioners, but rather what the two texts explicitly include in their provisions: a vitalistic and esoteric conception of the human body, based on invisible balances, key points, self-healing abilities and benefits enshrined in law.

Let us therefore examine the text of these draft bills in detail.

A.C. 1456 defines shiatsu as an ‘evolutionary technique’ intended to preserve health and activate the ‘ability to rebalance vital functions’ through pressure applied to areas, lines and points on the body. This is the traditional framework of Eastern ‘energy medicine’, stripped of the terms that would make its nature immediately recognisable. There is no mention of Ki, meridians or the flow of vital energy, but the underlying framework remains: the body is said to possess an overall balance; this balance may be disrupted; and pressure on specific points is said to be capable of restoring it. The ‘vital functions’ referred to in the text are not those defined by physiology and medicine, but a general and indistinct condition of the organism – that of vitalism, which always resurfaces in our bias-laden minds. Imbalance is not identified through measurable parameters, and rebalancing does not correspond to any defined clinical outcome. Vital energy disappears from the surface of the norm and returns under the seemingly neutral name of ‘ability to restore balance’. Article 3 of the same draft bill states in black and white that the pressure applied by the practitioner ‘restores all the body’s natural functions’ and stimulates the ‘body’s self-healing abilities’. There is no mention of relaxation or a possible subjective sense of well-being. It is stated that a manual practice restores all the body’s natural functions, without specifying a disease, a biological mechanism or a clinical outcome.

Self-healing is treated as a unified force within the body that shiatsu is said to be able to activate. Different processes, such as tissue repair, the immune response, functional recovery and the spontaneous resolution of symptoms, are grouped together under a general vitalistic principle. The practitioner is also credited with the ability to foster awareness of a person’s ‘bodily, relational and conflictual dynamics’, extending manual treatment to an undefined psychological dimension. Another draft bill, corresponding to A.C. 2742, uses more measured language but retains the same model. This text, too, asserts that shiatsu activates the ‘ability to rebalance vital functions’ through pressure on specific areas and points – here, too, therefore, vitalism and balancing-act nonsense are set out in black and white. Here too, the text reproduces the framework of a general balance of vital functions, which can be altered and restored by acting on specific points on the body. It is the very same structure that shiatsu organisations explicitly describe through Ki, the meridians and the circulation of vital energy, although these terms have been omitted from the legislative text.

The proposal put forward by Zanella adds that shiatsu produces ‘proven beneficial effects’. It does not specify what effects, for which conditions, in comparison to what, and, above all, on the basis of what evidence. The word ‘proven’ is inserted into the text as a legislative certification of efficacy. The evidence is not derived from clinical trials, systematic reviews or assessments by scientific bodies: it is produced by the legislation itself. These formulations do not appear merely in the explanatory reports, where they might be regarded as propaganda on the part of the proposers. They are written into the articles defining shiatsu. Should either of the two bills be passed, the State would formally recognise the existence of a balance of vital functions, the possibility of altering it through pressure on specific points on the body, a general capacity for self-healing, and the benefits of the discipline declared to be “proven”. Professionalisation is merely the vehicle: the substantive aim is to transform a vitalistic doctrine into regulatory content, enabling it to be taught, certified and presented to the public as part of a profession recognised by the Republic. A comparison with the doctrine set out by shiatsu organisations reveals the lexical translation carried out in the text: ‘Ki’ corresponds to the vital capacity for rebalancing; ‘meridians’ to the specific lines and points; and the restoration of energy flow to the rebalancing of vital functions.

The precedent of mototherapy, which has been designated by law as a ‘complementary therapy’, shows that the risk is not merely theoretical: a parliamentary majority can, by law, confer therapeutic status even in the absence of a robust, controlled and independently replicated clinical basis to justify it.

This is the crux of the matter: as with homeopathy and draft legislation on complementary medicines, the aim is to use the law to bypass science and introduce alternative models of reality into healthcare and educational institutions – models that lack empirical support and run counter to evidence-based medicine. Since the available data do not demonstrate the existence of the proclaimed general effects of rebalancing vital functions, activating self-healing or restoring all natural functions (whatever these constructs may mean), recourse is made to the law to declare them to be true. Legislation takes the place of evidence, because Parliament does not merely regulate a profession, but declares its underlying assumptions to be true. This becomes possible in a system that no longer monitors the correspondence between the claims enshrined in laws and the facts that can be ascertained. Ultimately, science is treated as just one of many possible opinions, and the scientific community as any other social body, a bearer of interests and nothing more: thus, in the Italian Parliament, facts disappear and evidence becomes blurred in an indistinct glimmer of interests to be reconciled.