Navigating ethical dilemmas in complementary and alternative medicine: a narrative review
Abstract
Complementary and alternative medicine (CAM) is a rapidly growing industry, with millions worldwide seeking these treatments for various ailments. While many CAM therapies have shown promise in improving health outcomes, there are also ethical challenges associated with them. In this article, we explore some of the most pressing ethical issues in CAM, including informed consent, justice in accessibility, and evidence-based therapies. This survey provides a comprehensive overview of the ethical issues in CAM and offers practical guidance for health-care providers navigating these complex issues. By understanding the ethical dilemmas in CAM, health-care providers can offer their patients safe and effective care while maintaining their professional and ethical obligations.
References:
Wai Fan K. National center for complementary and alternative medicine website. Journal of the Medical Library Association. 2005; 93(3): 410.
Tabatabaei Malazy O, et al. Quality of reporting of randomized controlled trials of herbal medicines conducted in metabolic disorders in Middle East countries: a systematic review. Complement Ther Med. 2018; 38: 61-6.
Tabatabaei Malazy O, Larijani B, and Abdollahi M. Targeting metabolic disorders by natural products. Journal of Diabetes & Metabolic Disorders. 2015; 14: 1-21.
Tabatabaei Malazy O, et al. New horizons in treatment of osteoporosis. DARU Journal of Pharmaceutical Sciences. 2017; 25: 1-16.
Moeini R, et al. The prevalence of complementary and alternative medicine use in the general population of Babol, North of Iran, 2018. BMC Complement Med Ther. 2021; 21(1): 113.
Nissen N, et al. Public health ethics for complementary and alternative medicine. European Journal of Integrative Medicine. 2013; 5(1): 62-67.
Chatfield K, et al. Applying an ethical framework to herbal medicine. Evidence-based Complementary and Alternative Medicine. 2018; 2018.
Welz AN, Emberger Klein A, Menrad K. Why people use herbal medicine: insights from a focus-group study in Germany. BMC Complementary and Alternative Medicine. 2018; 18: 1-9.
Organization WH, WHO traditional medicine strategy: 2014-2023. 2013: World Health Organization.
Javadi Pashaki N, et al. Methodological and ethical challenges for the implementation of complementary and alternative medicine-related clinical trials: review of reviews. Jorjani Biomedicine Journal. 2022; 10(3): 61-9.
Esmalipour R, Larijani B, Mehrdad N, Ebadi A, Salari P. The ethical challenges in pharmacy practice in community Pharmacies: a qualitative study. Saudi Pharm J. 2021;29(12):1441- 8.
White A, et al. Reducing the risk of complementary and alternative medicine (CAM): challenges and priorities. European Journal of Integrative Medicine. 2014; 6(4): 404- 8.
Pai Vasudev, et al. "Issues and challenges in pharmacovigilance of Herbal formulations." Current Drug Safety. 2024: 19-23.
Baatsch B, et al. Complementary and alternative therapies in dentistry and characteristics of dentists who recommend them. Complementary therapies in medicine. 2017; 35: 64-9.
Chowdhuri PD, and Kundu K. Factors determining choice of complementary and alternative medicine in acute and chronic diseases. J Complement Integr Med. 2020;17(3).
Richardson MA, et al. Complementary/alternative medicine use in a comprehensive cancer center and the implications for oncology. Journal of Clinical Oncology. 2000; 18(13): 2505-14.
Rosenthal DS, Dean Clower E. Integrative medicine in hematology/oncology: benefits, ethical considerations, and controversies. ASH Education Program Book. 2005(1): 491-7.
Oh W K, et al. Prospective, multicenter, randomized phase II trial of the herbal supplement, PC-SPES, and diethylstilbestrol in patients with androgen-independent prostate cancer. Journal of clinical Oncology. 2004. 22(18): 3705-12.
Zhang M, et al. Comparison of the guidelines on good agricultural and collection practices in herbal medicine of the European Union, China, the WHO, and the United States of America. Pharmacol Res. 2021; 167: 105533.
Gurgula O, Strategic patenting by pharmaceutical companies - should competition law intervene? IIC Int Rev Ind Prop Copyr Law. 2020; 51(9):1062-85.
Teichfischer P. Ethical implications of the increasing use of complementary and alternative medicine. Complementary Medicine Research. 2012; 19(6): 311-8.
Werner S M. Patient safety and the widespread use of herbs and supplements. 2014: Frontiers Media SA. p. 142.
Thelingwani R, Masimirembwa C. Evaluation of herbal medicines: value addition to traditional medicines through metabolism, pharmacokinetic and safety studies. Current Drug Metabolism. 2014: 15(10): 942-52.
Organization WH, National policy on traditional medicine and regulation of herbal medicines: Report of a WHO global survey. 2005: World Health Organization.
Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol 2014; 4: 177.
Ernst E, Cohen MH, Stone J. Ethical problems arising in evidence based complementary and alternative medicine. Journal of Medical Ethics. 2004; 30(2): 156-9.
Benzie IF, Wachtel-Galor S. Herbal medicine: Biomolecular and Clinical Aspects. 2011.
Organization WH. ICDRA: International conference of drug regulatory authorities (ICDRA) comes to Africa. WHO Drug Information. 2016; 30(2): 173-5.
ICDRA. 19th International Conference on Drug Regulatory Authorities. 2021, World Health Organization Geneva.
Mosihuzzaman M, Choudhary MI. Protocols on safety, efficacy, standardization, and documentation of herbal medicine (IUPAC Technical Report). Pure and Applied Chemistry. 2008; 80(10): 2195-2230.
Plantadosi S. In Clinical Trials: A Methodologic Perspective. New York: Johan Wiley & Sons, 2017.
Omur S. Ethical Evaluation of Clinical Research on Complementary and Alternative Medicine, IN Bioethics in Medicine and Society, Thomas FH, Sujoy R, Editors. Croatia: Intech Open, Rijeka. Ch. 7.
Communities C. The Rules Governing Medicinal Products in the European Community: Guidelines on the quality, safety, and efficacy of medicinal products for human use. Office for Official Publications of the European Communities.1989; Vol. 3.
Mashayekhi J, Mafinejad MK, Changiz T, Moosapour H, Salari P, Nedjat S, Larijani B. Exploring medical ethics' implementation challenges: a qualitative study. J Educ Health Promot. 2021; 10:66.
Madani M, Ghasemzadeh N, Dizani A, Gharamaleki AF, Larijani B. Policy considerations to achieve practical ethics: closing the gap between ethical theory and practic. J Med Ethics Hist Med. 2020; 13:8.
Salari P, Abdollahi M. Ethics in pharmacy curriculum for undergraduate pharmacy students: a needs assessment study. Arch Iran Med. 2017; 20(1): 38-42.
Chatfield K. Traditional and complementary medicine: analysing ethical challenges. Diss. University of Central Lancashire. 2016.
Di Paolo M, et al. Natural products in neurodegenerative diseases: a great promise but an ethical challenge. International Journal of Molecular Sciences. 2019; 20(20): 5170.
Seidlein AH, Salloch S. Illness and disease: an empirical-ethical viewpoint. BMC Med Ethics. 2019; 20(1): 5.
Taylor RM. Ethical principles and concepts in medicine. Handb Clin Neurol. 2013; 118: 1-9.
Childress JF. Respecting Personal Autonomy in Bioethics: Relational Autonomy as a Corrective? In James F. Childress & Michael Quante (eds.), Thick Autonomy: Personal Autonomy in Ethics and Bioethics. Germany: Springer Verlag; 2022. p. 135-49.
Emanuel EJ, et al. Ethical issues concerning research in complementary and alternative medicine, in The Ethical Challenges of Human Research: Selected Essays. UK: Oxford University Press; 2012.
Tilburt JC, Kaptchuk TJ. Herbal medicine research and global health: an ethical analysis. Bulletin of the World Health Organization. 2008; 86: 594-9.
Files | ||
Issue | Vol 17 (2024) | |
Section | Review Article(s) | |
DOI | https://doi.org/10.18502/jmehm.v17i3.15391 | |
Keywords | ||
Complementary medicine; Persian medicine; Alternative medicine; Ethics. |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |