Ethics for the Pediatrician: The Ethics of Complementary and Alternative Medicine

Abstract

1. Brenda J. Mears, MD* 1. *Department of Pediatrics, University of Texas at Southwestern Medical School, Dallas, Tex. Complementary and alternative medicine (CAM) is being used by a significant segment of society. To aid families who are using or considering CAM, pediatricians need to educate themselves about the available modalities and make this information available to these families. (1)(2) The 2007 National Health Interview Survey from the Centers for Disease Control and Prevention's National Center for Health Statistics estimated that 38.2% of adults and 11.8% of children had used some type of CAM in the preceding 12 months. (3) The rates may range as high as 70% in some groups. (4) In one survey, 87% of pediatricians had been asked by patients or parents about CAM, although as many as 66% may not tell their physicians when they do use CAM. (4)(5) Some of the cost of this care may be covered by insurance or government programs, but much is paid directly by families. The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health defines CAM as “a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.” Everything from whole medical systems such as homeopathy or naturopathy; mind-body medicine such as meditation, prayer, yoga, biofeedback, hypnosis, guided imagery, and art or music therapy; biologically based practices such as herbs, vitamins, and nutritional therapy; manipulative and body-based practices such as chiropractic or massage; and energy medicine such as biofield and bioelectromagnetic therapies has been considered CAM by some people. (6) When families use alternative medicine, these therapies are used instead of conventional medicine. Complementary medicine uses these therapies as …