SYMPOSIUM ON EVIDENCE BASED MEDICINE Ethical problems arising in evidence based complementary and alternative medicine

Received 13 November 2003 Revised version received 13 November 2003 Accepted for publication 27 November 2003 . . . . . . . . . . . . . . . . . . . . . . . T he popularity of complementary and alternative medicine (CAM) is considerable: the one year prevalence of CAM usage is 42% in the United States and 20% in the United Kingdom. As it turns out, at first glimpse, there are very few differences between the ethics of conventional medicine and those of CAM. In fact, many of the ethical rules applicable to conventional medicine—such as requirements of informed consent, practice boundaries (that is, the duty to practice within one’s scope of competence or else to appropriately refer), and duties involving confidentiality and privacy— translate across to the arena of CAM. In addition, much of the regulatory framework governing conventional medicine, which incorporates many ethical obligations, also translates to CAM practice. This includes, for example, licensure, malpractice liability rules, and legal rules governing professional discipline. The focus of this article is therefore on ethical aspects in areas of overt variations between CAM and conventional medicine. Because considerable national differences may exist, our article primarily focuses on CAM in the UK.