Ethics in CAM: An International Perspective

Yet another take on ethical issues in CAM, with an international twist, comes Ernst EE, Cohen MH, Stone J. Ethical problems arising in evidence-based complementary and alternative medicine. J Med Ethics 2004;30: 156-159. In this article, we examine some of the differences between conventional medicine and complementary and alternative medicine, and the implications of those differences for an ethics of CAM.

Our analysis includes training of CAM providers, and safety and efficacy of CAM therapies; research culture for these therapies; notions (or claims) of holism; and ways in which CAM therapies are regulated. Notably, in the U.K., professional self-regulation assumes an important role in setting high standards and curbing potential abuses. Except for chiropractors and osteopaths, most CAM providers in the U.K. are not statutorily regulated.

This was the situation in the U.S. colonies, but it changed with the advent of licensure. Politics and economics as well as public policy caused the shift (see Cohen MH, Complementary and Alternative Medicine: Legal Boundaries and Regulatory Perspectives), although the movement toward statutes allowing non-licensed providers to practice has succeeded so far in California, Minnesota, and Rhode Island.

My co-authors on the article are Brits Edzard Ernst, MD, PhD, Laing Chair in Complementary Medicine at Peninsula Medical School, Universities of Exeter & Plymouth, and Julie Stone, a lawyer-acupuncturist who co-authored a wonderful book entitled Complementary Medicine and the Law (addressing U.K. aspects of CAM regulation). Check out Dr. Ernst's Complementary Medicine website, detailing his journal FACT (Focus on Alternative and Complementary Therapies: An Evidence-Based Approach) and forthcoming conferences.