How Should We Respond to Non-Dominant Healing Practices, the Example of Homeopathy
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The debate around the ethics of homeopathy in recent issues of the journal has been approached as a binary question; is homeopathy ethical or not? This paper suggests that this is an unhelpful question and instead discusses a framework to establish the extent to which the dominant (medical) culture should tolerate non-dominant health practices such as homeopathy. This requires a sophisticated understanding of the placebo effect, a critical evaluation of what evidence is available, a consideration of the harm that the non-dominant practice might cause, and a consideration of how this might be affected by the culture of the patient. This is presented as a matter of cultural competence. At a clinical level clinicians need to respect the values and beliefs of their patients and communicate with all the practitioners involved in a patient’s care. At a societal level there are a number of factors to be considered when a community decides which practices to tolerate and to what extent.
KeywordsHomeopathy Ethics of placebo Cultural diversity Complementary and alternative medicine
- Accident Compensation Corporation. 2016. What support can I get. http://www.acc.co.nz/making-a-claim/what-support-can-i-get/WCM001816. Accessed November 22, 2016.
- Auckland University of Technology. 2016. Maori Dictionary OnLine. http://maoridictionary.co.nz/search?idiom=&phrase=&proverb=&loan=&histLoanWords=&keywords=tohunga. Accessed November 22, 2016.
- British Homeopathic Association. 2016. Homeopathy and the NHS. http://www.britishhomeopathic.org/what-is-homeopathy/homeopathy-and-the-nhs/. Accessed November 22, 2016.
- Doshi, P., T. Jefferson, and C. Del Mar. 2012. The imperative to share clinical study reports: Recommendations from the Tamiflu experience. PLoS Medicine 9(4): e1001201.Google Scholar
- Ehrlich, S. 2015. Homeopathy. University of Maryland Medical Center.http://umm.edu/health/medical/altmed/treatment/homeopathy. Accessed November 22, 2016.
- Fadiman, A. 1997. The spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus, and Giroux.Google Scholar
- Food and Drug Administration (FDA). 2000. Warning letter to Roche.http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/EnforcementActivitiesbyFDA/WarningLettersandNoticeofViolationLetterstoPharmaceuticalCompanies/UCM166329.pdf. Accessed November 22, 2016.
- Frank, J.D. 1971. Therapeutic factors in psychotherapy. American Journal of Psychotherapy.Google Scholar
- Goldacre, B. 2012. Bad pharma : How drug companies mislead doctors and harm patients. London: Fourth Estate.Google Scholar
- Grant, K. 2014. Ontario hospital cannot force chemo on 11-year-old native girl, court rules. The Globe and Mail, November 14. http://www.theglobeandmail.com/life/health-and-fitness/health/cancer-patient-has-right-to-use-aboriginal-healing-instead-of-chemo-judge-rules/article21587859/. Accessed November 22, 2016.
- Gray, B. 2016. Clinical ethics cultural competence and the importance of dialogue: A case study. Clinical Research and Bioethics 7(1): 1000256.Google Scholar
- Hall, H. 2013. Faith healing: Religious freedom vs. child protection. Skeptical Inquirer 38(4). http://www.csicop.org/si/show/faith_healing_religious_freedom_vs._child_protection. Accessed November 22, 2016.
- Hanna, M., and M. Honeychurch. 2015. Chronic misleading online advertising by chiropractors. The New Zealand Medical Journal 129(1432): 91–93.Google Scholar
- International Organization for Migration (IOM). 2015. World Migration Report. Geneva Switzerland. http://publications.iom.int/system/files/wmr2015_en.pdf. Accessed November 22, 2016.
- Levy, D., B. Gadd, I. Kerridge, and P. Komesaroff. 2014. A gentle ethical defence of homeopathy. Journal of Bioethical Inquiry 12(2): 1–7.Google Scholar
- Medical Council of New Zealand. 2006. Statement on cultural competence. http://www.mcnz.org.nz/assets/News-and-Publications/Statements/Statement-on-cultural-competence.pdf. Accessed November 22, 2016.
- Medical Council of New Zealand. 2011. Statement on complementary and alternative medicine. https://www.mcnz.org.nz/assets/News-and-Publications/Statements/Complementary-and-alternative-medicine.pdf. Accessed November 22, 2016.
- Ministry of Health New Zealand. 2015. Responsible authorities under the Act. http://www.health.govt.nz/our-work/regulation-health-and-disability-system/health-practitioners-competence-assurance-act/responsible-authorities-under-act. Accessed November 22 2016.
- New Zealand Council of Homeopaths. 2010. NZCH rules of practice and code of ethics. http://www.homeopathy.co.nz/assets/pdf/public/nzch-rules-of-practice-and-code-of-ethics-august-2010.pdf. Accessed November 22, 2016.
- New Zealand Medical Association. 2014. Code of ethics for the New Zealand medical profession. https://www.nzma.org.nz/__data/assets/pdf_file/0016/31435/NZMA-Code-of-Ethics-2014-A4.pdf. Accessed November 22, 2016.
- Pharmac. 2016. Rongoā Medicine. https://www.pharmac.govt.nz/maori/he-rongoa-pai/rongoa-medicine/. Accessed November 22, 2016.
- Pledger, M.J., J. Cumming, and M. Burnette. 2010. Health service use amongst users of complementary and alternative medicine. The New Zealand Medical Journal (Online) 123(1312): 26–35.Google Scholar
- Richardson, E. 2016. Health policy brief: Transparency in clinical research. Health Affairs, January 14. http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=150. Accessed November 22, 2016.
- Thomas, K., and M. Schmidt. 2012. Glaxo agrees to pay $3 billion in fraud settlement. New York Times, July 2.Google Scholar
- Tricoci, P., J.M. Allen, J.M. Kramer JM, R.M. Califf, and S.C. Smith. 2009. Scientific evidence underlying the ACC/AHA clinical practice guidelines. JAMA 301(8): 831–841.Google Scholar
- Washington, H.A. 2011. Deadly monopolies: The shocking corporate takeover of life itself, and the consequences for your health and our medical future. New York: Doubleday.Google Scholar