Ethical issues & conflicts of interest faced by the TCM practitioner

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Hi All,

 

See this from , posted to

Chinese Medicine

 

Phil

 

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" " <attiliodalberto

 

Here is an abstract of a forthcoming article by myself:

 

Research into the nature of TCM has descended into a downward

spiral. All the breakthroughs that were once foreseen almost 50

years ago and were awaited have become nothing but a wishful

dream. The whole field is currently in a state of disarray with basic

research coming to a standstill. This is because the relevant

substances in herbs are mostly unknown. If a therapy works, the

mechanism of action is normally unclear. It would be much more

complex and difficult to study the pharmacology, toxicity and

mechanisms of TCM herbal therapies as compared with drugs in

western medicine, which normally contain a single or a few known

compounds. This modern undertaking is a long way from the

ancient ideal, as laid down by Sun Szu-miao, of merely having the

divine guidance from God to be able to understand the mysterious.

The future can only hold a few possibilities for the integration of

TCM into Western culture. One is the changing of the Helsinki

research parameters to allow clinical efficacy to be conducted in

humans using randomised controlled trials. The other is to have a

closer look at the ethical issues that surround this ancient system

of healthcare that may support its use.

 

Ethics is the study of moral values or principles and are

expressions that characterize professional practice in society.

Evidence is scarcer than in mainstream medicine, leading to the

often subjective, therapeutic decisions being based upon opinion

rather than evidence. However, within TCM treatment and any

healthcare system, the role of health care worker's duty is defined

by their ideas and beliefs as to the nature of what they would

consider a medical treatment and this may well be based upon a

religious or philosophical model. Traditional is

practised in countries in which laws and professional codes of

ethics are based on another philosophical tradition. What is clear

is that patients or clients fall within the scope of the health care

workers' duty of beneficence. TCM is chiefly based upon

beneficence and the belief that it is effective in the treatment of

illness, more so than its potential harmful effects, of which a small

number have been noted. Dilemmas usually occur when there is a

conflict of interest between the TCM practitioner, the medical

evidence, the law and the patient. However, it is always the case

that whenever we try to help others we inevitably risk harming

them. We therefore need to make sure that we are offering each

patient a net benefit.

 

It is my view that the importance of beneficence far out-weighs non-

maleficence and the need for evidence-based research, although it

is much needed and every effort should be maintained to cultivate

its growth. The ethical argument for the administration of a non-

evidence based medicine should be swayed above-all towards the

need to treat human illness. Therefore, the issue of prescribing

herbal formulas to humans is in truth ethical sound even if the

evidence disallows it.

 

Attilio

 

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Best regards,

 

 

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