With the prevalence of complementary and alternative medicine (CAM) increasing in western societies, questions of the ethical justification of these alternative health care approaches and practices have to be addressed. In order to evaluate philosophical reasoning on this subject, it is of paramount importance to identify and analyse possible arguments for the ethical justification of CAM considering contemporary biomedical ethics as well as more fundamental philosophical aspects. Moreover, it is vital to provide adequate analytical instruments for (...) this task, such as separating ‘CAM as belief system’, and ‘CAM as practice’, Findings show that beneficence and non-maleficence are central issues for an ethical justification of CAM as practice, while freedom of thought and religion are central to CAM as belief system. Many justification strategies have limitations and qualifications that have to be taken into account. Singularly descriptive premises in an argument often prove to be more problematic than universal ethical principles. Thus, non-ethical issues related to a general philosophical underpinning - e.g. epistemology, semantics, and ontology - are highly relevant for determining a justification strategy, especially when strong metaphysical assumptions are involved. Even if some values are shared with traditional biomedicine, axiological differences have to be considered as well. Further research should be done about specific CAM positions. These could be combined with applied qualitative social research methods. (shrink)

It is doubtful that any feature of the American health care system in the last several decades has had as profound an effect on the way Americans pursue their perceived health needs as complementary and alternative medicine. Almost half of all Americans take care of some of their health care needs outside of contemporary scientific medicine. The number of visits to CAM practitioners was estimated 6 years ago to be 629 million a year, with expenditures of (...) $27 billion a year. The use of CAM has been expanding rapidly despite little objective evidence of its safety or effectiveness. Little more than a decade ago CAM was viewed by the traditional medical community as a nuisance that offered unproven treatments at best and as outright quackery at worst. In any case, alternative medicine, as it was known at that time, seemed unworthy of serious attention. (shrink)

In recent years so-called Complementary and Alternative Medicine practices have made significant political and professional advances particularly in the United Kingdom : osteopathy and chiropractic were granted statutory self-regulation in the 1990s effectively giving them more professional autonomy and independence than health care professions supplementary to medicine ; the practice of acupuncture is widespread within the National Health Service for pain control; and homoeopathy is offered to patients by a few General Practitioners alongside conventional treatments. These (...) developments have had a number of consequences: one is that both CAM and Conventional and Orthodox Medical professions have had to reappraise their professional identity. In manual therapy for example, questions have been asked about the differences between physiotherapy, osteopathy and chiropractic, and what the justification is for having separate professions. A wider question concerns the relationship between CAM and COM; are CAM distinct professions or should they, as has happened to a limited extent in the UK, be absorbed into the broader field of ‘ Medicine ’ or ‘Health Care’ as adjunctive therapies. CAM professions have also had to develop, implement and enforce codes of practice for practitioners and clarify the scope of practice within a profession. At the heart of these issues lies the need to identify and clarify professional values. A key claim of CAM professions is that their practice is distinct and the outcome of treatment at least as effective and in many cases more effective than with conventional therapies. In addition, what counts as effective outcome is often different from conventional medical understanding, involving more subtle humanitarian considerations, for example. Three values are identified as being commonly held across CAM professions. These are: offering ‘natural’ treatment; being patient rather than disease focussed; and being holistic. However, these may not be as distinctive of CAM as is claimed either because the meaning is unclear or because COM professions claim similar values. The paper argues that the values that inform ‘good practice’ and ‘effective outcome’ should be seen as distinct components of professional competence. This has implications for establishing professional identity and codes of practice. (shrink)

My presentation was set as a counterpoint to the presentation by Lawrence Schneiderman, M.D., “Alternative Medicine or Alternatives to Medicine.”’ In this talk, Dr. Schneiderman vigorously critiqued CAM on the basis of evidence-based science as opposed to what he called “the collective romantic fantasy” of CAM. will challenge this science-versus-CAM view on the basis of several limits to science. My thesis here is: (1) the basic methods of science are as appropriate to the study of CAM as (...) they are to the study of conventional medicine (that is, there are some limits in both cases, but they are not special exemptions for CAM); however, (2) the human actors who practice science are cultural and emotional beings and the enterprise of science is therefore limited by human capacities. This is not a controversial claim, because human limitations in science are well-recognized. (shrink)

Subjective probabilities play a significant role in the assessment of evidence: in other words, our background knowledge, or pre-trial beliefs, cannot be set aside when new evidence is being evaluated. Focusing on homeopathy, this paper investigates the nature of pre-trial beliefs in clinical trials. It asks whether pre-trial beliefs of the sort normally held only by those who are sympathetic to homeopathy can legitimately be disregarded in those trials. The paper addresses several surprisingly unsuccessful attempts to provide a satisfactory justification (...) for ignoring the pre-trial beliefs of the homeopathic community. The ensuing diagnosis of the difficulties here emphasizes that the reason the arguments for choosing the pre-trial beliefs of the conventional community seem insufficient is not the arguments per se. It is rather that there is no cogent argument for choosing the conventional stance which would at the same time rationally persuade a member of the homeopathic community. The paper concludes that, once we understand that this is the predicament, there is no genuine reason to doubt the reasoning that leads us to reject the pre-trial beliefs of the homeopathic community. (shrink)

This article considers various approaches used in complementary and alternative medicine research, and discusses the challenges that reviewing such research poses for Human Research Ethics Committees. Drawing on our experience with the University of Technology Sydney HREC, we offer some suggestions about how ethical principles governing conventional medical research can be applied in the context of research in complementary and alternative medicine. We argue that effective HREC review requires members to gain familiarity with such (...) research, which helps ensure that such research is conducted rigorously and ethically. (shrink)

In this article we explore the role evidence ought to play in complementary and alternative medicine. First, we consider the claim that evidence in the form of randomized controlled trials cannot be obtained for CAMs. Second, we consider various claims to the effect that there are ways of obtaining evidence that do not make use of RCTs. We argue that there is no good reason why CAM should be exempted from the general requirement that treatments undergo evaluation (...) by RCT. Third, we consider two implications for health care policy. First, many activities in conventional medicine have never been rigorously evaluated and are widely in use nonetheless. We argue that this fails to provide a reason for exempting CAM from a demand for evidence. Second, CAM use may be compared to a choice of lifestyle, and this has a significant impact on which requirements of evidence can reasonably be imposed. (shrink)

Complementary and alternative medicine is used by many in hopes of achieving important health-related goals. Survey data indicate that 42 percent of the U.S. population uses CAM, accounting for 629 million “office” visits a year and expenditures of 27 billion dollars. This high prevalence of use calls for a careful evaluation of CAM so as to ensure the well-being of those using its modalities. Such an evaluation would obviously include assessments of the safety and efficacy of particular (...) approaches, the training and integrity of practitioners, and the appropriateness of modalities for different conditions or uses. Given the lack of published data concerning many of these aspects of CAM, the likely unfamiliarity of its practitioners to the approaches available to clinicians practicing modern scientific medcine, and the need to respect the unique preferences of persons seeking assistance with achieving health-related goals, it is also important to assess the potential roles of informed consent for the use of CAM. Examining such roles is the central task of this paper. (shrink)

Complementary and alternative medicine has become an important section of healthcare. Its high level of acceptance among the general population represents a challenge to healthcare professionals of all disciplines and raises a host of ethical issues. This article is an attempt to explore some of the more obvious or practical ethical aspects of complementary and alternative medicine.

Complementary and alternative medicines (CAM) have become increasingly popular over recent decades. Within bioethics CAM has so far mostly stimulated discussions around their level of scientific evidence, or along the standard concerns of bioethics. To gain an understanding as to why CAM is so successful and what the CAM success means for health care ethics, this paper explores empirical research studies on users of CAM and the reasons for their choice. It emerges that there is a close connection (...) to fundamental principles of medical ethics. The studies also highlight that CAM’s holistic ontology of health and illness has an empowering effect on people in caring for their health, and on an even deeper level, safeguards against biomedicine’s reducing image of oneself as biological body-machine. The question is raised what lessons bioethics should draw from this emancipatory social movement for its own relationship with biomedicine. (shrink)

Background Medical research in complementary and alternative medicine (CAM) has increased recently, raising ethical concerns about the moral status of CAM. Medical academic journals are responsible for conducting ethical review (ER) of manuscripts to protect the interests of human subjects and to make ethical results available before deciding to publish. However, there has been no systematic analysis of the ER in CAM journals. This study is aim to evaluate the current status of ethical requirements and compliance in (...) CAM journals. Methods This is a cross-sectional study. We reviewed instructions for authors (IFAs) of CAM journals included in the Journal Citation Reports (2021) (https://jcr.clarivate.com) for general information and requirements for ER. We also browsed the manuscripts regarding randomized controlled trials published by CAM journals in Q1 and Q2 section from January to June, 2023, to check the actual situation of ethical requirement. Descriptive statistics and Fisher’s exact test were used for statistical analysis. Results 27 journals and 68 manuscripts were ultimately included. 92.6% (25/27) IFAs included keywords of ER, indicating the presence of ethical considerations. However, no specific ER was required for CAM (n = 0). We categorized journals by Geographic origin, JCR section, Year of electronic JCR, Types of studies, % of OA Gold to explore the factors that could influence CAM journals to have certain ethical review policies. The results showed there was no statistical significance in certain ethical review policy in any classification of journals (p > 0.05). All RCT manuscripts included in the study generally met the requirements of the published journals for ethical review. Conclusions All IFAs discussed ER, but the content was scattered, unfocused, and there were no specific ER requirements regarding CAM. Although the manuscripts basically met the requirements of the journal, it was not possible to get closer to the process of ER in the manuscript. To ensure full implementation of these policies in the future, CAM journals should require authors to provide more details, or to form a list of items necessary for CAM ethical review. (shrink)

This book reveals the numerous ways in which moral, ethical and legal principles are being violated by those who provide, recommend or sell ‘complementary and alternative medicine’. The book analyses both academic literature and internet sources that promote CAM. Additionally the book presents a number of brief scenarios, both hypothetical and real-life, about individuals who use CAM or who fall prey to ethically dubious CAM practitioners. The events and conundrums described in these scenarios could happen to almost (...) anyone. Professor emeritus of complementary medicine Edzard Ernst together with bioethicist Kevin Smith provide a thorough and authoritative ethical analysis of a range of CAM modalities, including acupuncture, chiropractic, herbalism, and homeopathy. This book could and should interest all medical professionals who have contact to complementary medicine and will be an invaluable reference for patients deliberating which course of treatment to adopt. (shrink)

About one-third of Australians use the services of complementary and alternative medicine (CAM); but debate about the role of CAM in public healthcare is vociferous. Despite this, the mechanisms driving CAM healthcare choices are not well understood, especially in rural Australia. From 2016 to 2018, 2,679 persons from the Goulburn Valley, northern Victoria, were surveyed, 28% (755) of whom reporting visiting CAM practitioners. A Generalized Linear Mixed Model was used to assess associations between various socio-demographic variables and (...) the use of CAM services. The strongest significant inverse (p < 0.05) association with CAM use overall was being unemployed, with markedly lower odds of using CAM than those employed full-time (OR 0.22 [0.12, 0.41]). The next strongest inverse relationship was being retired (OR 0.44 [0.30, 0.65]). The strongest positive associations were with English spoken at home (OR 2.38 [1.34, 4.24]), private health insurance (hospital cover) (1.57 [1.28, 1.91]), being Australian born (OR 1.61 [1.14, 2.28]), and female sex (1.25 [1.02, 1.52])). Females had significantly higher odds of using osteopathy than males (OR 1.98 [1.33, 2.96]) but there were no significant sex differences for chiropractic or massage. This is the first such study conducted solely for a rural Australian population. The drivers of CAM use differed from previous nation-wide studies and they varied across modalities. The factors identified here as being associated with CAM use could be used by CAM practitioners in developing person-centred services. Similarly, the findings are relevant to primary-care services in understanding what sectors of society might eschew conventional health care for CAM in rural regions, where health services are often limited. (shrink)

The more popular complementary and alternative medicine (CAM) has become, the more often it is demanded that the integration of CAM should be limited to those approaches that are scientifically proven to be effective. This paper argues that this demand is ethically and philosophically questionable. The clinical legitimacy being gained by CAM and its increasing informal integration should instead caution against upholding the biomedical framework and evidence-based medicine as conditions of acceptance. Patients’ positive experiences with CAM (...) deserve a truly scientific exploration of non-biomedical conceptualizations of health and illness. It is also problematic to request scientific evidence when there is proven resistance against CAM in research institutions, under-funding and a lack of suitable research methodologies. This is even more so, when much conventional medicine is not practiced with the same level of evidence as demanded from CAM. (shrink)

Against the backdrop of the political intrigue in biomedicine’s ascendancy to orthodoxy, this article examines its contemporary rapprochement with Complementary Alternative Medicine (CAM), in the move toward an integrated medical regime. It also identifies and explores factors underlying the rapprochement, as well as different ethical challenges that face integrated medicine. It argues that a major approach to tackling these challenges hinges on devising just and equitable criteria for evaluating the efficacy of plural therapeutic paradigms inherent in (...) CAM models. This is attainable through a policy that encourages creating public health policy and medical personnel deliberately exposed as part of their curriculum to the philosophical and theoretical features of diverse therapeutic traditions. (shrink)

This paper argues that it is morally irresponsible for modern medical providers or health care institutions to support and advocate the integration of CAM practices (i.e. homeopathy, acupuncture, energy healing, etc.) with conventional modern medicine. The results of such practices are not reliable beyond that of placebo. As a corollary, it is argued that prescribing placebos perceived to stand outside the norm of modern medicine is morally inappropriate. Even when such treatments do no direct physical harm, they create (...) unnecessary barriers to patients' informed understanding of their health. (shrink)

Concerns about the possibility of a sharp rise in the prevalence of Alzheimer’s disease in Western nations have led to both the significant deployment of resources and the development of national research and healthcare plans. Although often focused on treatment, substantial efforts have also been dedicated toward preventing or delaying AD onset. As a result, recent technological and biomedical advances have greatly improved the understanding of AD pathophysiology. While some new tests can assess only risk ), some tests for certain (...) biomarkers (e.g., amyloid beta accumulation in the brain detected via positron... (shrink)

Growing interest in complementary and alternative veterinary medicine (CAVM) has sparked a debate among veterinarians, who claim such therapeutic modalities fall under the purview of veterinary medicine, and non-veterinarians, who argue that several modalities do not require the rigorous training of a veterinarian to be performed safely. The veterinary profession must proactively redefine its definition of the practice of veterinary medicine in the face of increasing challenges to state practice acts. By looking to human (...) class='Hi'>medicine as a model for how to balance conventional and alternative modalities, the profession can develop a system that provides animal caregivers access to CAVM while still safeguarding animal health. (shrink)

In caring for pediatric patients, a multifaceted approach in decision-making is utilized. The role of the medical team in complementary and alternative medicine is controversial. In cases of conventional treatment refusal by parents in pursuit of complementary and alternative medicine, there must be balanced decision-making, autonomy, and the best interest of the child. This report highlights two illustrative cases (ages 4, 17 years) of patients with brain tumor, whereby parents refused postoperative conventional therapy involving (...) chemoradiotherapy, in pursuit of complementary and alternative medicine alone. Parental decision-making in complementary and alternative medicine, in lieu of medical recommendations, poses an ethical and legal dilemma that may impede care of the pediatric patient and compromise outcome of oncological care. (shrink)

Complementary and alternative medicine (CAM) research presents unique problems for research ethics committees which must be considered in some detail. Applying conventional research techniques to CAM raises a number of issues which ethics committees may find challenging. CAM is widely available and this will have a substantial effect on any proposed research strategy as so many individuals will have pre-existing opinions about these treatments. Whilst many complementary therapies may eventually be ‘validated’ by appropriate clinical trial methodologies (...) other research methods could be more appropriate in the early stages of a research strategy, particularly in view of the widespread availability in both the public and private sectors. Safety, efficacy, cost-effectiveness and patient preference also need evaluation; and these cannot be adequately assessed through double blind randomised placebo controlled trials. If the research question is clear, then thoughtful and often innovative evaluative processes can be designed to answer the socially and clinically relevant issues posed by this area of medicine. There are a number of agencies and organizations available to offer advice to ethics committees in this newly emerging field of CAM research including CAM Strategy Research and Development (CAM STRAND), the Foundation for Integrated Health (FIH) and the Research Council for Complementary Medicine (RCCM). (shrink)

The use of complementary and alternative medicine (CAM) by US consumers has grown in recent years. CAM therapies often utilize medicinal herbs as part of the treatment process; however, research on US practitioner preferences for medicinal herbs is limited, despite growing concern surrounding the sustainability of wild-harvested medicinal herbs. In order better to understand consumer preferences for this emerging market, a mail survey of US practitioners (licensed acupuncturists) was conducted to examine the importance of five herb attributes (...) in practitioners’ herb selection decisions: (1) country of origin, (2) freshness, (3) production method (organic versus conventional), (4) price, and (5) traceability. The significance of these five traits is investigated using discrete choice analysis, and the implications for US medicinal herb growers are discussed. (shrink)

Analysis of the debate concerning the appropriate way of researching the effects of complementary and alternative medicine (CAM) treatments highlights the controversial issue of the mind–body bond in medical research. The article examines a range of approaches, extending from outright opposition to CAM research, through the demand to employ only rigorous trials, to suggestions to use a hierarchy of evidence, up to practice‐based research proposals. These diverse approaches are analysed using theoretical concepts from the field of sociology (...) of science and knowledge. The article uses the concept of “hybrid knowledge” to denote the knowledge being constructed in late modern CAM discourse—knowledge that hybridises differentiated and even contradictory modern categories of knowledge. The article suggests that the different approaches taken by sociologists of science and knowledge, such as strong anti‐dualism and the assertion that there are differences in our understanding of the natural and the cultural–social terrain, are all useful and are not necessarily mutually exclusive. The article seeks to clarify the debate concerning the appropriate way of researching CAM and to contribute to the ongoing development and application of sociology of knowledge. (shrink)

In evidence-based medicine (EBM), methodology has become the central means of determining the quality of the evidence base. The “gold standard” method, the randomised, controlled trial (RCT), imbues medical research with an ethos of disinterestedness; yet, as this essay argues, the RCT is itself a rhetorically interested construct essential to medical-professional boundary work. Using the example of debates about methodology in EBM-oriented research on complementary and alternative medicine (CAM), practices not easily tested by RCTs, I frame (...) the problem of method as a fundamentally rhetorical problem, situated within a boundary drama, and deeply rooted in the discursive practices of science and medicine. The genre of the RCT report, for example, idealises the research process and can tilt the course of arguments about CAM, while the notion of efficacy can function as a rhetorically mobile boundary object that can redefine the very terms of debate. I suggest herein that arguments about method in CAM debates can productively be read, metonymically, as expressions of more general anxieties in medicine about knowledge and evidence, community values, and professional boundaries; as such, these debates can illuminate some of the rhetorical dimensions of EBM. (shrink)

Complementary and alternative medicine is becoming increasingly popular in western countries, with estimates of CAM usage as high as 40%. This has prompted a change of attitude of the medical establishment: the initial dismissal of CAM is being replaced by a drive to integrate CAM into the mainstream. Two possible explanations for this integration thrust are considered. Firstly, integration could be motivated largely by cognitive interest in CAM. Secondly, integration could be mainly power-driven, aimed at controlling the (...) alternative movement and exploiting its capacity to make money. The second explanation seems more plausible, and is supported by data showing the paucity of research on CAM. The medical establishment does not sufficiently appreciate the challenge CAM poses, and does not consider its scientific appraisal to be a high priority. Instead, the allopathic community seems preoccupied with the opportunistic desire to protect its authority and social status. Such a discourse can become dogmatic, reluctant to revise critically the ‘accepted’ body of knowledge. Popper's critical rationalism could help to undercut dogmatism and encourage a critical, open-minded orientation of medical science. (shrink)

There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of (...) science that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards. (shrink)

Modern scientific medicine is increasingly challenged by complementary and alternative therapies. Reviewing policy options for contemporary healthcare development, the World Health Organization's first global strategy on traditional and alternative medicine, released in May 2002, advocates integration. However, experience in East Asia, the only part of the world where state of the art modern scientific facilities are commonly found alongside thriving traditional practices, reveals that medical integration can take several forms. To clarify the available policy options, (...) this article categorizes those forms, identifying three types of integration (unification, equalization and subjugation), plus one type of non-integration (marginalization). It marks out a zone of balanced healthcare development that cuts across two of the integrationist types, and comprises non-discriminatory state treatment of separate but linked sectors of traditional and modern medicine. The article closes by exploring arguments for and against locating state policy in this zone, and holds that policy should be situated here for medical practices that can meet broadly acceptable professional standards, demonstrate an existing social demand, and generate an adequate supply of medical practitioners, possibly through some state subsidy. (shrink)

This paper is a critique of ‘integrative medicine’ as an ideal of medical progress on the grounds that it fails to realise the cognitive value of alternative medicine. After a brief account of the cognitive value of alternative medicine, I outline the form of ‘integrative medicine’ defended by the late Stephen Straus, former director of the US National Centre for Complementary and Alternative Medicine. Straus’ account is then considered in the light (...) of Zuzana Parusnikova’s recent criticism of ‘integrative medicine’ and her distinction between ‘cognitive’ and ‘opportunistic’ engagement with alternative medicine. Parusnikova warns that the medical establishment is guilty of ‘dogmatism’ and proposes that one can usefully invoke Karl Popper’s ‘critical rationalism’ as an antidote. Using the example of Straus, I argue that an appeal to Popper is insufficient, on the grounds that ‘integrative medicine’ can class as a form of cognitively-productive, critical engagement. I suggest that Parusnikova’s appeal to Popper should be augmented with Paul Feyerabend’s emphasis upon the role of ‘radical alternatives’ in maximising criticism. ‘Integrative medicine’ fails to maximise criticism because it ‘translates’ alternative medicine into the theories and terminology of allopathic medicine and so erodes its capacity to provide cognitively-valuable ‘radical alternatives’. These claims are then illustrated with a discussion of ‘traditional’ and ‘medical’ acupuncture. I conclude that ‘integrative medicine’ fails to exploit the cognitive value of alternative medicine and so should be rejected as an ideal of medical progress. (shrink)

With the increased acceptance of complementary and alternative medicine (CAM) within society, new research reflects deeper folk health histories beyond formal medical spaces. The contested relationships between formal and informal medicine have deep provenance and as scientific medicine began to professionalise in the 19th century, lay health knowledges were simultaneously absorbed and disempowered (Porter 1997). In particular, the ‘medical gaze’ and the responses of informal medicine to this gaze were framed around themes of power, (...) regulation, authenticity and narrative reputation. These responses were emplaced and mobile; enacted within multiple settings by multiple agents and structures over time. The work is drawn from secondary material from Ireland, which identify more indigenous narratives of health and act as potential sources for medical humanities. While assumptions have been made as to the place of folk-medicine being essentially rural, evidence will be presented which shows a more complex network of health beliefs and practices. The narratives of informal practice and folk-medicine drawn from evidence from Ireland point to more fluid and hybrid relations with formal medicine and suggest that the complementary nature of the two models reflected wider cultural debates and models of belief (Del Casino Jnr., Health & Place 10:59-73, 2004). (shrink)

The main purpose of this article is to explore, from an ethical perspective, one particular branch of what is today called “spiritual medicine”: namely, prayer therapy. Several landmark studies in the literature will be thoroughly examined, respectively the classical study of Byrd (1988), the replica of Harris et al. (1999), and the controversial study of Leibovici (2001). Beginning with these studies and the related controversies surrounding them, the religious features and ethical consequences of prayer therapy are investigated. The ethical (...) aspects of prayer therapy – the informed consent issue, the issue of respecting bioethical principles, and the issue of medical competence in offering such techniques – are thoroughly addressed. Finally, an alternative way of framing the prayer therapy discussion is offered, in the context of public-private dichotomy. (shrink)

The discussion about complementary and alternative medicine is sometimes rather heated. “Quackery!” the cry goes. A large proportion “of unconventional practices entail theories that are patently unscientific.” “It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and (...) medicine that may or may not work.” “I submit that if these treatments cannot withstand the test of empirical research, … then we have wasted a lot of time and effort. The time has been wasted on all the people who have spent years learning falsehoods about acupuncture points and the principles of homeopathy. And the patients have wasted their time, money, and efforts receiving treatments that were not what they were represented to be or were harmful.”. (shrink)

The validity of clinical trials for certain alternative treatments has been called into question by supporters of unconventional and pseudoscientific practices, who criticize the way their beliefs are investigated scientifically or the verdicts reached by science. This chapter focuses on the following basic question: what treatments can be scientifically investigated at all? It aims to provide a better understanding of what conditions medical treatments must fulfill to be eligible for scientific investigation. In particular, the discussion is a rejoinder to (...) the claims put forward by adherents of alternative medicine that their treatments are inaccessible to scientific scrutiny. (shrink)

This book provides a systematic analysis of the ethical implications of traditional and complementary medicine, focusing on pragmatic solutions. The author uses a bioethical methodology called the “Ethical Matrix,” to consider the impact of T&CM use for animals and the environment as well as for humans. A systematic search of the literature reveals that most published ethical concerns are related to the safety of T&CM use for humans. However, application of the Ethical Matrix demonstrates that the ethical implications (...) for T&CM use are much broader. In this book, the author analyses the most serious implications, including adverse events related to homeopathy, the use of animals in T&CM products, and the impact of herbal medicine on the environment. Comparisons with the ethical implications of conventional biomedicine help readers to contextualise debate, and highlight aspects that may be unique to T&CM. Globally, many high-level health policy makers promote T&CM as an accessible and affordable healthcare option. However, their use is considered by some to be a waste of resources, unscientific, and unethical. Offering a frank analysis of this largely ignored field of healthcare ethics, this book is both timely and essential. It helps patients, policy makers, practitioners, researchers, and students gain the knowledge they need to make more informed decisions. (shrink)

Alternative medicine is hugely popular; about 40% of the US general population have used at least one type of alternative treatment in the past year, and in Germany this figure is around 70%. The money spent on AM is considerable: the global market is expected to reach nearly US $ 200 billion by 2025, with most of these funds coming directly out of consumers’ pockets. The reasons for this popularity are complex, but misinformation is certainly a prominent (...) factor. The media seem to have an insatiable appetite for the subject and often report uncritically on it. Misinformation about AM on the Internet is much more the rule than the exception. Consumers are thus being bombarded with misinformation on AM, and they are ill-protected from such misinformation and therefore prone to making wrong, unwise or dangerous therapeutic decisions, endangering their health and wasting their money. This book is a reference text aimed at guiding consumers through the maze of AM. The concept of the book is straightforward. It has two main parts. The first, short section provides essential background on AM, explaining in simple terms what is good, reliable evidence, and addressing other relevant issues like, for instance, the placebo response, informed consent, integrative medicine, etc. The second and main part consists of 150 short chapters, topically grouped and each dedicated to one single alternative therapeutic or diagnostic method. In each of them, seven critical points are raised. These points relate to issues that are important for consumers’ decisions whether it is worth trying the method in question. Restricting the discussion to just seven points means that issues must be prioritized to those themes which are most relevant in the context of each given modality. (shrink)

Regina R. is a 12-year-old girl with recently diagnosed insulin-dependent diabetes. Before discharging her from the hospital, her family physician and consulting diabetes specialist try to instruct the girl and her parents in the appropriate program of treatment, including diet, insulin, and regular self-monitoring. However, the parents become upset when they learn what is involved in insulin treatment and inform the family physician they plan to employ the services of an alternative healing clinic that promises to cure their daughter (...) with a combination of herbal potions, macrobiotics, aroma therapy, therapeutic touch, Ayurveda, homeopathy, and guided imagery. (shrink)

Small, mundane technologies, such as stethoscopes, medicinal bottles, labels, cleaning and dispensing equipment, are integral to the practice of western herbal medicine in the UK. A focus on such technologies reveals the dynamic character and porousness of medical systems and allows us to identify cultural interactions. In this photo essay, based on long-term anthropological research, I explore an assemblage of everyday technologies used by WHM practitioners and the ways in which these technologies contribute to shaping diagnostic stories, to performing (...) medical legitimacy and invoking herbal traditions. The biomedical, herbal and domestic technologies-in-use come into view as vibrant and dynamic objects with highly contingent meanings and identities. Their absorption into this non-biomedical therapy supports the performance of medical legitimacy, authority, tradition and professionalism, while the use of everyday domestic objects may signal female-coded practices of care. This demonstrates the adaptability of a medical practice situated at the margin of mainstream healthcare and subject to ongoing technological and ideological influence. The strategic integration of this assemblage of everyday technologies into WHM contributes, I suggest, to evoking a competent, trustworthy and time-honoured medical practice, which is simultaneously inscribed with multiple tensions, ambiguities and contestations. (shrink)

SummaryThis article analyses the viewpoints of doctors, patients and the state of the phenomenon of unconventional methods of treatment/alternative medicine in Slovenia. The doctors’ viewpoints are taken from the official documents of the Medical Chamber of Slovenia and the Slovene Medical Association. The patients’ viewpoints are established on the basis of public opinion and epidemiological research, carried out in 1994 and 1996 on two representative samples of the Slovene population from the Celje area. The estimation of the attitude (...) of the state is based on legislation and other regulations connected with alternative medicine. The findings of our analysis show a strongly negative attitude of doctors to any form of alternative medicine. In contrast, as many as half the patients express a favourable opinion on alternative methods of treatment, and more than a third of them actually make use of them. From existing laws it is evident that the state in general does not deal with alternative medicine, except for possibilities in such cases when a doctor or some other healthcare professional uses alternative methods of treatment. Alternative medicine is, from the point of view of social medicine, a phenomenon that should be followed, analysed and controlled. Dangerous as well as protective factors which accompany the exceution of alternative methods should be recognised so as to be able to inform the public of the results in a timely and accurate manner. Because of the need for the legal and healthcare security of Slovene citizens, the state should regulate existing unconventional treatments. (shrink)