[Chinese Traditional Medicine] Ethical issues & conflicts of interest faced by the TCM practitioner

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The BSc (Hons) degree i attend at Middlesex University touches upon ethics twice but only in a light way. It seems that within the TCM framework, ethics is somehow not an importance. As if TCM is except or rather already has ethical issues 'built' into it as it is a holistic medicine. This is far from the truth, and we, as TCM practitioners, really need to take a step back and look, not only at the ethical issues faced by us but also the lack of foundation research which supports our cause.

 

The abstract raises the issue of research. I feel that the majority of TCM pracitioners are happy to let large governement agencies or medical companies conduct research on their behalf when in fact, unvariable results are more likely to emerge and hold CM back in the dark ages. Are reviewing a nujmber of research papers myself, i have noticed the lack of syndrome differentiation used in research along with the lack of training undertaken in CM by the therapist. Other factors also contribute to a negative outcome and a poor methodology used. This can only be harmful to CM. More TCM practitioners need to take research into their own hands and help CM 'break' into WM model.

The ethical issues faced by TCM practitioners are often unique when compared to WM. Thus a great deal of discussion is needed to point the TCM pracitioner in the right direction. Not only for CM as a whole but also for the personal TCM practitioner who may be faced with litigation later.Emmanuel Segmen <susegmen wrote:

 

 

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

 

Hi Attilio,

 

Thank you for your post. I'm noticing no one responded to your meditation on ethics which I feel is central to some of the conflict that currently exists between WM an CM.

 

As a point of information, I've not seen an MD curriculum with ethics. Are medical ethics a part of your Oriental medicine degree? Ethics is a large part of every masters in nursing degree I've seen. I had to take a graduate seminar in ethics regarding genetic engineering in my various graduate programs leading to an engineering certificate. I sense that ethics is largely missing in our current medical paradigm from both purely clinical as well as research orientation. There's plenty of legislation and litigation, but not a whole lot of medical ethics being addressed above the MSN level.

 

The paradigm of WM research seeks molecular mechanisms, but as you imply most responsible pharmacologists will note that no such bio-assay exists for solutions that contain thousands of interacting chemical compounds. Our HPLC markers are for the highest independent peaks of chemical compounds that are easily characterized. These are useful for testing batch work in factories. None of these could be considered "active ingredients" apart from the rest of the solution. They are markers for use in manufacturing. Clinical studies can and are done by the thousands these days for CM formulas, but invariably the investigators indicate that what ever the results are, the biochemical mechanism is unknown. In my humble opinion, I view this as perfectly fine. I hope for more studies regarding clinical outcomes and less pressure on ferreting out molecular structures. Of course, molecules is where the

money is. Clinical outcomes is where the healing is.

 

Emmanuel Segmen

Merritt College, Asia Natural