Abstract
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.
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References
Silenzio, V. M. B. (2002). What is the role of complementary and alternative medicine in public health? American Journal of Public Health, 92, 1562–1564.
Eisenberg, D. M., Davis, R. B., Ettner, S. L., Appel, S., Wilkey, S., Van Rompay, M., et al. (1998). Trends in alternative medicine use in the United States, 1990–1997. Results of a follow-up national survey. Journal of the American Medical Association, 280, 1569–1575.
World Health Organization. (2002). WHO traditional medicines strategy 2002–2005. Geneva: World Health Organization.
Snyderman, R., & Weil, A. T. (2002). Integrative medicine: Bringing medicine back to its roots. Archives of Internal Medicine, 162, 395–397.
Callahan, D. (2002). Introduction. In D. Callahan (Ed.), The role of complementary and alternative medicine. Accommodating pluralism (p. vii–x). Washington DC: Georgetown University Press.
Angell, M., & Kassirer, J. P. (1998). Alternative medicine – The risks of untested and unregulated remedies. The New England Journal of Medicine, 339, 839–841.
Fontanarosa, P. B., & Lundberg, G. D. (1998) Alternative medicine meets science. Journal of the American Medical Association, 280, 1618–1619.
Ernst, E. (1996). The ethics of complementary medicine. Journal of Medical Ethics, 22, 197–198.
Komesaroff, P. A.(1998). Use of complementary medicines: Scientific and ethical issues. Medical Journal of Australia, 169, 180–181.
Gruner, J. (2000). Complementary medicine, evidence based medicine and informed consent. Monash Bioethics Review, 19, 13–27.
Ernst, E., & Cohen, M. H.(2001). Informed consent in complementary and alternative medicine. Archives of Internal Medicine, 161, 2288–2293.
Kopelman, L. M. (2002) The role of science in assessing conventional, complementary, and alternative medicines. In D. Callaghan (Ed.), The role of complementary and alternative medicine. Accommodating pluralism (p. 36–53). Washington DC: Georgetown University Press.
Ernst, E., Cohen, M. H., & Stone, J. (2004). Ethical problems arising in evidence based complementary and alternative medicine. Journal of Medical Ethics, 30, 156–159.
Parker, M. (2007). Two into one won’t go: Conceptual, clinical, ethical and legal impedimenta to the convergence of CAM and orthodox medicine. Journal of Bioethical Inquiry, 4(1), doi:10.1007/s11673-007-9031-z (this issue).
Clark-Grill, M. M. (2004). Reclaiming the full story of human health: The ethical significance of complementary and alternative medicines. Doctoral Thesis, University of Otago.
Lyng, S. (1990). Holistic health and biomedical medicine. A countersystem analysis. Albany: State University of New York Press.
Nordin, I. (2000). Expert and non-expert knowledge in medical practice. Medicine, Health Care and Philosophy, 3, 297–304.
Willis, E., & White, K. (2004). Evidence-based medicine and CAM. In P. Tovey, G. Easthope, J. Adams (Eds.), The mainstreaming of complementary and alternative medicine (p. 49–63). London: Routledge.
Astin, J. A. (1998). Why patients use alternative medicine. Journal of the American Medical Association, 279, 1548–1553.
Fisher, P., van Haselen, R., Hardy, K., Berkovitz, S., & McCarney, R. (2004). Effectiveness gaps: A new concept for evaluating health service and research needs applied to complementary and alternative medicine. Journal of Alternative and Complementary Medicine, 10, 627–632.
Hocquard, T. J. (2002). Fibromyalgia: An opportunity to explore the human experience of disability, and the implication for rehabilitation. New Zealand Family Physician, 29, 380–382.
Malterud, K. (2002). Understanding the patient with medically unexplained disorders – A patient-centred approach. New Zealand Family Physician, 29, 374–379.
Murdoch, C. (2002). The fruits of unbelief. New Zealand Family Physician, 29, 383–384.
O’Connor, B. B. (2002). Personal experience, popular epistemology, and complementary and alternative medicine research. In D. Callaghan (Ed.), The role of complementary and alternative medicine (p.54–73). Washington DC: Georgetown University Press.
Mason, S., Tovey, P., & Long, A. F. (2002). Evaluating complementary medicine: Methodological challenges of randomised controlled trials. British Medical Journal, 325, 832–834.
Long, A. F., Mercer, G., & Hughes, K. (2000). Developing a tool to measure holistic practice: A missing dimension on outcomes measurement within complementary therapies. Complementary Therapies in Medicine, 8, 26–31.
Lukoff, D., Edwards, D., & Miller, M. (1998). The case study as a scientific method for researching alternative therapies. Alternative Therapies, 4, 44–52.
Kiene, H.(2001). Komplementäre Methodenlehre der klinischen Forschung: Cognition-based medicine. Berlin: Springer.
Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L. V., et.al. (1997). Are the clinical effects of homeopathy placebo effects? A meta-analysis of placebo-controlled trials. The Lancet, 350, 834–843.
Shang, A., Huwiler-Müntener, K., Nartrey, L., Jüni, P., Dörig, S., Sterne, J. A. C., et. al. (2005). Are the clinical effects of homoeopathy placebo effects? Comparative study of placebo-controlled trials of homoeopathy and allopathy. The Lancet, 366, 726–732.
Frass, M., Linkesch, M., Banyai, S., Resch, G., Dielacher, C., Löbl, T., et. al. (2005). Adjunctive homeopathic treatment in patients with severe sepsis: A randomized, double-blind, placebo-controlled trial in an intensive care unit. Homeopathy, 94, 75–80.
Bell, I. R., Lewis, D. A., Brooks, A. J., Schwartz, G. E., Lewis, S. E., Walsh, B. T., et. al. (2004). Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology, 43, 577–582.
Vandenbroucke, J. P., & de Craen, A. J. M. (2001). Alternative medicine: A “mirror image” for scientific reasoning in conventional medicine. Annals of Internal Medicine, 135, 507–513.
Vandenbroucke, J. P. (2002). Alternative treatments in reproductive medicine. The vexing problem of “seemingly impeccable trials...”. Human Reproduction, 17, 2228–2229.
Morreim, E. H. (2003). A dose of our own medicine: Alternative medicine, conventional medicine, and the standards of science. The Journal of Law, Medicine & Ethics, 31,222–235.
Haynes, B., & Haines, A. (1998). Barriers and bridges to evidence based clinical practice. British Medical Journal, 317, 273–276.
Naylor, C. D. (1995). Grey zones of clinical practice: Some limits to evidence-based medicine. The Lancet, 345, 840–842.
Kenny, N. P. (1997). Does good science make good medicine? Incorporating evidence into practice is complicated by the fact that clinical practice is as much art as science. Canadian Medical Association Journal, 157, 33–36.
Bauchner, H. (1999). Evidence-based medicine: A new science or an epidemiologic fad? Pediatrics, 103, 1029–1031.
Cranney, M., Warren, E., Barton, S., Gardner, K., & Walley, T. (2001). Why do GPs not implement evidence-based guidelines? A descriptive study. Family Practice, 18, 359–363.
Knottnerus, A., & Dinant, G. J. (1997). Medicine based evidence, a prerequisite for evidence based medicine. British Medical Journal, 315, 1109–1110.
Culpepper, L., & Gilbert, T. T. (1999). Evidence and ethics. The Lancet, 353, 329–331.
Rosser, W. W. (1999). Application of evidence from randomized controlled trials to general practice. The Lancet, 353, 661–664.
Van Weel, C., & Knottnerus, J. A. (1999). Evidence-based interventions and comprehensive treatment. The Lancet, 353, 916–918.
Stevenson, F. A., Barry, C. A., Britten, N., Barber, N., & Bradley, C. P. (2000). Doctor–patient communication about drugs: The evidence for shared decision making. Social Science and Medicine, 50, 829–840.
Eskinazi, D. P. (1998). Factors that shape alternative medicine. Journal of the American Medical Association, 280, 1621–1623.
Hufford, D. J. (2003). Evaluating complementary and alternative medicine: The limits of science and of scientists. The Journal of Law, Medicine & Ethics, 31, 198–212.
House of Lords’ Select Committee on Science and Technology Complementary and Alternative Medicine. (2000). London: The Stationary Office.
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Clark-Grill, M. Questionable Gate-keeping: Scientific Evidence for Complementary and Alternative Medicines (CAM): Response to Malcolm Parker. Bioethical Inquiry 4, 21–28 (2007). https://doi.org/10.1007/s11673-007-9035-8
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DOI: https://doi.org/10.1007/s11673-007-9035-8