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Informed Consent, Shared Decision-Making, and Complementary and Alternative Medicine

Published online by Cambridge University Press:  01 January 2021

Extract

Complementary and alternative medicine (CAM) is used by many in hopes of achieving important health-related goals. Survey data indicate that 42 percent of the U.S. population uses CAM, accounting for 629 million “office” visits a year and expenditures of 27 billion dollars. This high prevalence of use calls for a careful evaluation of CAM so as to ensure the well-being of those using its modalities. Such an evaluation would obviously include assessments of the safety and efficacy of particular approaches, the training and integrity of practitioners, and the appropriateness of modalities for different conditions or uses. Given the lack of published data concerning many of these aspects of CAM, the likely unfamiliarity of its practitioners to the approaches available to clinicians practicing modern scientific medcine, and the need to respect the unique preferences of persons seeking assistance with achieving health-related goals, it is also important to assess the potential roles of informed consent for the use of CAM. Examining such roles is the central task of this paper.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 2003

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References

Eisenberg, D.M. et al., “Trends in Alternative Medicine Use in the United States, 1990–1997: Results of a Follow-Up National Survey,” JAMA, 280 (1998): 1569–75.CrossRefGoogle Scholar
Sugarman, J. and Burk, L., “Physicians' Ethical Obligations Regarding Alternative Medicine,” JAMA, 280 (1998): 1623–25.CrossRefGoogle Scholar
Cohen, M.H., “The Informed Consent Obligation,” in Cohen, M. H., Beyond Complementary Medicine: Legal and Ethical Perspectives on Health Care and Evolution (Ann Arbor: University of Michigan Press, 2000): 3745; Vincler, L.A. and Nicol, M.F., “When Ignorance Isn't Bliss: What Healthcare Practitioners and Facilities Should Know about Complementary and Alternative Medicine,” Journal of Health and Hospital Law, 30(1997): 160–78.Google Scholar
Faden, R.R. and Beauchamp, T.L., A History and Theory of Informed Consent (New York: Oxford University Press, 1986).Google Scholar
United States v. Karl Brandt et al., “The Medical Case, Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10,” (Washington, D.C.: Government Printing Office, 1949); World Medical Association, Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects, rev. ed. (Edinburgh: 52nd World Medical Association General Assembly, October 2000).Google Scholar
Beauchamp, T.L. and Childress, J.F., Principles of Biomedical Ethics, 4th ed. (New York: Oxford University Press, 1994).Google Scholar
45 C.F.R. § 46 (2003).Google Scholar
See Vincler, and Nicol, , supra note 3.Google Scholar
Ernst, E. and Cohen, M.H., “Informed Consent in Complementary and Alternative Medicine,” Archives of Internal Medicine, 161 (2001): 2288–92.CrossRefGoogle Scholar
Lyons, T.R., “Herbal Medicines and Possible Anesthesia Interactions,” AANA Journal, 70 (2002): 4751; Valli, G. and Giardina, E.G.V., “Benefits, Adverse Effects and Drug Interactions of Herbal Therapies with Cardiovascular Effect,” Journal of the American College of Cardiology, 39 (2002): 1083–95.Google Scholar
Ruhl, TS., Ernst, E., and Cohen, M.H., “Spiritual Informed Consent for CAM,” Archives of Internal Medicine, 162 (2002): 943–44.Google Scholar
Boozang, K.M., “Western Medicine Opens the Door to Alternative Medicine,” American Journal of Law & Medicine, 24 (1998): 185212.CrossRefGoogle Scholar
45 C.F.R. § 46.102 (2003).Google Scholar
Dietary Supplement Health and Education Act, Pub. L. No. 103–417, 108 Stat. 4325 (1994).Google Scholar
Brody, B. A., The Ethics of Biomedical Research: An International Perspective (New York: Oxford University Press, 1998).Google Scholar
Charles, C., Gafni, A., and Whelan, T., “Shared Decision-Making in the Medical Encounter: What Does It Mean? (Or It Takes at Least Two to Tango),” Social Science and Medicine, 44 (1997): 681–92.Google Scholar
Clouser, K.D. and Hufford, D.J., “Informed Consent and Alternative Medicine,” Alternative Therapies, 2 (1996): 7677. See Ernst, and Cohen, , supra note 9.Google Scholar
See Charles, , Gafni, , and Whelan, , supra note 16.Google Scholar
Winslow, L.C. and Shapiro, H., “Physicians Want Education About Complementary and Alternative Medicine to Enhance Communication with Their Patients,” Archives of Internal Medicine, 162 (2002): 1176–81.CrossRefGoogle Scholar
See Sugarman, and Burk, , supra note 2.Google Scholar
See Eisenberg, et al., supra note 1.Google Scholar