Institute of Medicine Report Features Ethical Values

The Institute of Medicine's Report on Complementary and Alternative Medicine in the United States highlighted five ethical values to be held in balance during clinical decision-making.

These values are: a social commitment to public welfare; a commitment to protect patients and the public from hazardous health practices; a respect for patient autonomy; recognition of medical pluralism; and public accountability.

The media accounts by and large focused on the recommendations involving dietary supplements. No attention thus far has been paid to the ethical framework, which includes other values than the usual pair of non-maleficence and autonomy.

Regarding the ethical value of medical pluralism, the report notes: "Serious consideration of the safety, efficacy and potential integration of CAM therapies into conventional medicine means acknowledgement of multiple valid modes of healing, and a pluralistic foundation for health care....[P]ublic accountability, like medical pluralism, must include some consideration of the vast array of perspectives that constitute the national (and even international) heritage of healing traditions." (pp. 174, 177)

These definitions add to the notion of a larger ethical balancing test for clinical decision-making involving CAM use.

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