Controversial Practice Research Articles

Missing History: Anarcha, Betsey, and Lucy’s Legacy in Gynecologic Textbooks

Abstract The legacy of J. Marion Sims as the “father of gynecology” has become widely controversial among medical professionals and lay public because of ethical concerns surrounding the development of his surgical techniques and his exploitation of enslaved women for his experiments. Notably, in April 2018, the City of New York relocated a commemorative statue of Sims from Central Park following an art commission’s investigation of his controversial practices. The relocation was viewed by many as a public acknowledgement of the contributions of Anarcha, Betsey, Lucy, and the other enslaved women to the advancement of gynecologic surgery. However, despite the increased public awareness of the women’s sacrifices in recent years medical literature has not kept pace. We compared the portrayal of Sims and these enslaved women within current gynecology textbooks, prior editions, and historical medical literature. We found that gynecologic textbooks more often mention J. Marion Sims by name (74%) compared to the enslaved women he experimented on (24%). Neither current gynecologic surgery textbooks nor primary historical sources contain significant references to these women, meaning much of their story has been lost to history. While there has been increased public knowledge of the sacrifices of Anarcha, Betsey, and Lucy and other enslaved women, lay recognition is not enough. Full acknowledgment of their contributions necessitates crediting their roles in Sims’ experiments and stating their names in medical literature.

Herbal Products: Considerations and Educational Resources for Oncology Nurses.

The use of herbal products, one component of the growing field of integrative cancer care, is a common yet controversial practice. This article distinguishes nursing issues specific to patient safety when herbal products are used during cancer treatment and identifies available evidence-based resources to enhance patient and professional comprehension. PubMed®, CINAHL®, and Google Scholar™ databases were searched for literature published between 2018 and 2024 specific to the clinical sequelae of the use of herbal products and their interactions with antineoplastic drugs, as well as patient and healthcare providers' perceptions of efficacy and safety. Patients have misconceptions about the use of herbal products and are generally unaware of these products' potential contraindications when taken in conjunction with antineoplastics. Providers seldom inquire about patients' use of these products and may lack knowledge of their potential interactions with prescription medicines.

Conducting mixed methods research with women in a forensic mental health setting: A reflexive account from a nurse as researcher.

To describe a reflexive account of a mental health nurse as researcher undertaking a mixed methods study as part of a doctoral degree, with women in a secure forensic hospital. A discursive paper that draws upon the primary author's experience of dual roles as a mental health nurse and a novice researcher, and relevant literature pertaining to positionality and reflexivity in the context of conducting mixed methods research. A mixed methods study was conducted within a secure forensic hospital in Australia, to identify factors associated with the frequency and duration of seclusion for women and, to explore their experiences of seclusion. Notes and a reflective diary were used to demonstrate the reflexive approach and strategies used throughout the study design and data collection stages of the research. Women in the secure forensic hospital setting often have complex histories and experiences and are considered a vulnerable group, which can add additional challenges when undertaking research with this population. As a doctoral student with clinical experience in mental health undertaking research in the forensic hospital setting with women, positionality and the connection with reflexivity requires exploration to understand self and the influence on research. This understanding along with identified strategies to enhance reflexivity, supports the management of the dual nurse as researcher roles to enhance all stages of the research process. Doctoral nursing candidates undertaking clinical research in their area of clinical practice and at the location of previous employment, may experience challenges in relation to identity and the dichotomy of roles. Further challenges can be posed when research involves complex populations and/or controversial practices. Support to balance role conflict and maintain reflexivity is critical to understanding the role of self in research and to enhance credibility. Women are a complex, yet minority population in forensic mental health settings, however the numbers of women being admitted to services is increasing. Future research may consider the use of the strategies explored here to enhance the reflexive process, and support future researchers in this field to conduct research that aims to support an often-misheard population to better support health outcomes. There was no patient or public contribution to this paper, however the study in which this paper is based on, is grounded in the experience of patients (women).

A complementary approach to Critical Frame Analysis and ‘what is the Problem represented to Be?’

ABSTRACT Critical Frame Analysis (CFA) is a method for analyzing policy framing by excavating rhetorical meaning. In contrast, ‘What is the Problem Represented to Be?’ (WPR) is a method for critiquing common assumptions underpinning public policy by questioning unexamined knowledges. CFA is constructivist WPR is constructionist. Can two policy methods from different research paradigms be used in tandem? Scholars do not agree if this is possible; those who do say little about why and how to do it. I argue that although CFA and WPR have distinct metatheoretical foundations, process-oriented researchers doing single case and small n studies can use both in tandem to produce more rigorous, critical scholarship. I explain why using them in a complementary fashion is not only possible but also desirable and illustrate how to do it by drawing on examples from three dissimilar policy debates about controversial gender practices like veiling.

Consumer acceptance of different types of cultural borrowing and its internal mechanisms

In cross-regional cultural interactions, the frequent and controversial practice of cultural borrowing has attracted attention. According to the different relative statuses and comparative directions of the cultural subjects, cultural borrowing can be divided into strong-to-weak (weak-to-strong) cultural borrowing between subjects with strong (weak) status and subjects with weak (strong) status in cultural interactions, as well as equal cultural borrowing between subjects with equal status in cultural interactions. After the concept and types of cultural borrowing are defined, a multisituation experimental method is used to confirm the internal mechanisms and effect boundaries of consumers’ cultural borrowing acceptance. The results of five experiments based on over a thousand subjects indicate that different types of cultural borrowing (strong-to-weak, equal, weak-to-strong) arouse consumers’ perceived cultural threat, thereby reducing their acceptance of cultural borrowing to varying degrees. The influence of different types of cultural borrowing on perceived cultural threat is moderated by the degree of incongruent use and reality of the presentation of the borrowed culture; the influence of perceived cultural threat on cultural borrowing acceptance is moderated by the positioning of the borrowing subjects and the degree of identity in the relationship. By exploring cultural borrowing and consumer acceptance issues in the field of consumption through a series of experiments, this study effectively reveals the differentiated impacts and underlying mechanisms of different types of cultural borrowing on consumers’ acceptance responses.

Optimized high-dose granulocyte transfusions for the treatment of infections in neutropenic patients: A single-center retrospective analysis.

Granulocyte transfusions for patients with prolonged neutropenia and severe infections has been a controversial practice. Previous studies suggest a benefit of high-dose granulocyte transfusions (≥0.6 × 109/kg), although, until recently, the consistent production of high-dose units has been challenging. Here, we present our experience and results utilizing high-dose granulocyte transfusions at a large, tertiary academic medical center for the treatment of infections in adult, neutropenic patients. A retrospective chart review (2018-2021) was conducted for all patients who received high-dose granulocyte transfusions from donors stimulated with granulocyte colony-stimulating factor (G-CSF) and dexamethasone. Gathered parameters included patient demographics, clinical history, infection status, dose, clinical outcomes, pre- and post-absolute neutrophil count (ANC), and transfusion times including time between granulocyte collection, administration, and posttransfusion ANC count. Gathered parameters were summarized using descriptive statistics, outcomes were assessed utilizing Kaplan-Meier curves/log-rank/regression testing. Totally 28 adult, neutropenic patients refractory to antimicrobial agents and/or G-CSF received a total of 173 granulocyte concentrates. Median ANC increased from 0.7 × 109/L pre-transfusion to 1.6 × 109/L posttransfusion. The mean granulocyte yield was 77.4 × 109 resulting in an average dose per kilogram of 0.90 × 109 ± 0.30 × 109 granulocytes. Composite day 42 survival and microbial response was 42.9% (n = 12/28) without significant adverse reactions. Here, we demonstrate the successful and safe implementation of high-dose granulocyte transfusions for neutropenic patients. Given the rapid and consistent production, distribution, and improved granulocyte quality, further investigations to determine the clinical efficacy of G-CSF primed granulocyte transfusions is now possible.

CHALLENGES OF BRIDE BUYING WOMEN (MOLKI) IN HARYANA

Bride buying, a controversial practice prevalent in certain regions of India, particularly in Haryana, raises significant ethical and social concerns. This paper explores the challenges faced by women who are bought as brides, including social stigma, lack of autonomy, economic dependence, and psychological issues. By examining the cultural and socio-economic context of Haryana, this paper aims to highlight the challenges faced by women purchased for marriage purpose and to understand the impact on the society at large. In the end, some suggestions are also given to provide better living for purchased brides. Bride buying, a practice rooted in socio-economic and cultural complexities, has significant implications for women in Haryana, India. This study explores the multifaceted challenges faced by women who become brides through this transactional system. Central to these challenges are issues of autonomy and agency, as many women are treated as commodities rather than individuals with rights and desires. Economic burdens placed on families often lead to financial exploitation, further ingrained poverty and limiting educational and career opportunities for these women. Additionally, the psychological impacts of bride buying, including feelings of worthlessness and depression, are profound, as societal norms perpetuate stigma and isolation. Legal frameworks aimed at addressing dowry-related practices often fall short, leaving women vulnerable and unprotected. This paper underscores the urgent need for inclusive policy interventions and community awareness programs not only to encounter the challenge of bride buying in Haryana but also promote gender equality and empower women in Haryana.

Healthcare consumers’ perceptions of incentive-linked prescribing: A scoping review

Incentive-linked prescribing (ILP) is considered a controversial practice universally. If incentivised, physicians may prioritise meeting pharmaceutical sales targets through prescriptions, rather than considering patients’ health and wellbeing. Despite the potential harms of ILP to patients and important stakeholders in the healthcare system, healthcare consumers (HCCs) which include patients and the general public often have far less awareness about the practice of pharmaceutical incentivisation of physicians. We conducted a scoping review to explore what existing research says about HCCs’ perceptions of the financial relationship between physicians and pharmaceutical companies. To conduct this scoping review, we followed Arksey and O’Malley’s five-stage framework: identifying research questions, identifying relevant studies, selecting eligible studies, data charting, and collating, summarising, and reporting results. We also used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ extension for scoping reviews (PRISMA-ScR), as a guide to organise the information in this review. Quantitative and qualitative studies with patients and the general public, published in the English language were identified through searches of Scopus, Medline (OVID), EMBASE (OVID), and Google Scholar. Three themes emerged through the analysis of the 13 eligible studies: understanding of incentivisation, perceptions of hazards linked to ILP, and HCCs’ suggestions to address it. We found documentation that HCCs exhibited a range of knowledge from good to insufficient about the pharmaceutical incentivisation of physicians. HCCs perceived several hazards linked to ILP such as a lack of trust in physicians and the healthcare system, the prescribing of unnecessary medications, and the negative effect on physicians’ reputations in society. In addition to strong regulatory controls, it is critical that physicians self-regulate their behaviour, and publicly disclose if they have any financial ties with pharmaceutical companies. Doing so can contribute to trust between patients and physicians, an important part of patient-focused care and a contributor to user confidence in the wider health system.

Does the holy grail of the evidence pyramid vindicate the controversial practice of endometrial scratching or is there room for healthy skepticism?

Does the holy grail of the evidence pyramid vindicate the controversial practice of endometrial scratching or is there room for healthy skepticism?

THE NOTION OF SANCTIONS IN THE DOCTRINE OF INTERNATIONAL LAW

The article explores the issue of sanctions in international law with a focus on defining the term. This topic has been of interest to researchers for many years, but there is still no universally accepted approach to resolving it, both in terms of international law doctrine and its sources. This lack of clarity in terminology creates practical problems related to controversial practices in applying sanctions and their subsequent legal assessment from the perspective of international law. Given the increasing number of sanctions regimes, it is crucial to address these issues urgently. While foreign legal literature has made systematic attempts to tackle this problem, domestic literature has not paid sufficient attention to the concept of sanctions. Taken together, these factors point to the expediency of conducting this study, which aims to outline the range of measures that are defined as sanctions in modern international law. Based on the analysis conducted, it is argued that the science of international law adopts two approaches in defining sanctions. The first, broad approach suggests that the concept of sanctions should encompass coercive measures taken by the injured state individually as self-help in the form of countermeasures and retorsions to ensure compliance with the violated obligations by the offending state, as well as coercive measures taken collectively by the UNSC under Chapter VII of the UN Charter to restore international legality. Instead, the second, narrower approach defines sanctions exclusively as coercive measures applied by the UNSC under Chapter VII of the UN Charter. The author concludes that the narrow approach is currently regarded as prevailing in the science and aligns with the provisions of modern international law. Simultaneously, attention is drawn to the widespread phenomenon of so-called “unilateral sanctions” in the world practice, the definition and legal nature of which also remain controversial. The review of existing definitions concludes that they all share the common understanding of these measures as coercive measures taken by a state, group of states, or international organizations without the approval of the UNSC, with the intention of compelling another state to change its policy. This understanding of “unilateral sanctions” distinguishes them from “sanctions” in the strict sense of the term and as defined by the prevailing narrow approach. Nonetheless, the practice of state relations shows the widespread use of these measures and their identification as “sanctions” in domestic legislation. This suggests that, in reality, there are two distinct coercive measures referred to as “sanctions” in today’s international reality. These include coercive measures taken by the UNSC under Chapter VII of the UN Charter, as well as coercive measures taken by a state, a group of states, or international organizations without the approval of the UNSC to compel another state to change its policy.

The Active Form of Security: Technology and the Material-aesthetic Script

How are socially and politically controversial security practices materially-technologically scripted into our lives in ever-deeper ways? This essay proposes that acts of aesthetic design are at the heart of that process and are being deployed by technology corporations to “smooth” the diffusion of security practices, discourses, and politics across global space. To substantiate that claim, we make three moves. First, we propose an understanding of the “script” that returns to the roots of the concept in theater and the arts. That understanding stresses that our material-technological enmeshing is governed strongly by aesthetic and affective factors that operate through forms of resonance (rather that reason). In consequence—we argue—much of the power of technology conglomerates is linked to their capacity to harness these aesthetico-affective resonances. Second, we demonstrate this through a case study focused on the material-aesthetic design activities of Google, teasing out how it deploys aesthetic practices to extend its sociopolitical power. Third, we speculatively conclude by introducing the architect Keller Easterling’s concept of “active form” to show how conceptualizing scripts in aesthetic terms also provides insights into how security practices are diffused across global contexts, irrelevant contextual sociopolitical differences, and seemingly without any limit.

Overlapping Surgery Verbiage in Informed Consent Documents.

To assess informed consent documents from United States (US) institutions for verbiage regarding overlapping surgery. Overlapping surgery remains a controversial practice. Recent guidance from the Senate Finance Committee and American College of Surgeons emphasizes transparency with patients regarding this practice through the informed consent process, but it remains unclear how many institutions adopted their recommendations. Informed consent documents were collected from a national sample of 104 institutions and assessed for verbiage regarding overlapping surgery and/or attending absence during a surgical case. The verbiage of these forms was further analyzed for inclusion of key terms (e.g., "overlapping surgery," "critical portions") as well as transparency regarding surgeon absence. Thirty (29%) forms included verbiage regarding overlapping surgery and/or surgeon absence during a case. Most of these 30 utilized the terms "overlapping surgery" or "critical portions" (18 [60%] and 25 [83%], respectively), although only 3 (10%) explicitly stated that portions of the procedure that may be performed in the absence of the attending surgeon. Six forms (20%) specifically stated who may perform the procedure without the attending present, and 3 forms (10%) had patients acknowledge this section of the consent form with an additional signature or initial. Only 2 of the forms (7%) fulfilled all of the criteria set forth by the SFC. Detailed information regarding overlapping surgery is infrequently included in hospitals' procedure informed consent documents. Forms that include this information rarely provide explicit statements of attending presence and trainee participation, raising concerns regarding surgeon-patient transparency.

Large-Caliber Empiric Esophageal Dilation Results in Sustained Improvement for Selected Patients With Nonobstructive Dysphagia.

Empiric esophageal dilation (EED) remains a controversial practice for managing nonobstructive dysphagia (NOD) secondary to concerns about safety and efficacy. We examine symptom response, presence of tissue disruption, and adverse events (AEs) after EED. We examined large-caliber bougie EED for NOD at 2 tertiary referral centers: retrospectively evaluating for AEs. Esophageal manometry diagnoses were also reviewed. We then prospectively assessed EED's efficacy using the NIH Patient-Reported Outcomes Measurement Information System disrupted swallowing questionnaire to assess dysphagia at baseline, 1, 3, and 6 months after EED. Treatment success was defined by improvement in patient-reported outcome scores. AE rate for large-caliber dilation in the retrospective cohort of 180 patients undergoing EED for NOD was low (0.5% perforations, managed conservatively). Visible tissue disruption occurred in 18% of patients, with 47% occurring in the proximal esophagus. Obstructive motility disorders were found more frequently in patients with tissue disruption compared with those without (44% vs 14%, P = 0.05). The primary outcome, the mean disrupted swallowing T -score was 60.1 ± 9.1 at baseline, 56.1 ± 9.5 at 1 month ( P = 0.03), 57 ± 9.6 at 3 months ( P = 0.10), and 56 ± 10 at 6 months ( P = 0.02) (higher scores note more symptoms). EED resulted in a significant and durable improvement in dysphagia and specifically solid food dysphagia among patients with tissue disruption. EED is safe in solid food NOD and particularly effective when tissue disruption occurs. EED tissue disruption in NOD does not preclude esophageal dysmotility.

Geographical variation in compulsory mental health care: cause for concern and source of causal inference

IntroductionCompulsory mental health care remains a controversial practice. The many difficulties in performing Randomised Controlled Trials (RCT) on the topic means there is limited evidence to support its effectiveness. For ethical and legal reasons, compulsory mental health care should only be used when necessary. Yet, geographical variations, which can indicate both overuse and underuse, have been observed. In the funded research project “Controversies in Psychiatry” we intend to use this variation as a source of knowledge production. We propose that this naturally occurring variation mimics randomisation, and can therefore permit causal inference from registry data.ObjectivesWe will estimate the causal effect of compulsory inpatient mental health care on a range of outcomes, including injuries, self-harm, and all-cause mortality; violent crime; employment vs benefit allowance; rehospitalisation and outpatient commitment.MethodsObserved variation in register data on all episodes of compulsory inpatient mental health care in Norway between 2015-2016 (N ≈ 300 000), will serve as a source of as-random variation. Provider-preference for compulsion usage will be used as an instrumental variable (IV).ResultsOutcomes will be observed from 2017-2025. If assumptions underlying IV-analysis do not hold, the project will still provide important and complete descriptive data on long-term outcomes for a whole population.ConclusionsGeographical variation is a cause for concern if people are treated differently depending on area of residence. But it also presents an opportunity to use differences in service provider’s preference for using compulsory care as an instrumental variable to estimate the causal effect of compulsory care on multiple short and long-term outcomes. This approach can help resolve controversies that are difficult or even impossible to investigate through RCTs. After presenting the project plan we invite to a discussion of the feasibility of using an instrument variable approach to explore if relatively low versus high rates of compulsory care produce favorable outcomes for patients.Disclosure of InterestNone Declared

“My friend, my friend, free try, free try”: An investigation of peddling activities through implicit self-theory

Hawking and peddling activities are common in tourist attractions to elicit tourist patronage. These controversial practices add vibes to the destination for some but are considered annoying to others. Based on the implicit theories, this paper aims to explore how the lay beliefs of individuals affect customer perceptions towards these practices and the tourist destination. Forty-one semi-structured interviews were conducted at hawking sites in Macao to examine how individuals with divergent mindsets react towards a spectrum of characteristics associated with peddling activities. The findings reveal that entity and incremental theorists form distinct evaluations, encompassing factors such as risk assessment, meaning attribution, experience connections, brand recognition, signalling, and stereotypes. These perceptions are developed throughout different information processing stages, including attention allocation, encoding, retrieval, and reasoning. These results provide insights for businesses and DMOs in administering peddling activities by ensuring accurate information, promoting fair practices and enforcing a trustworthy judicial system.

Nursing students' attitude toward euthanasia following its legalization in Spain.

Euthanasia is a controversial practice in many countries. Since Spain's Euthanasia Law came into effect on March 24, 2021, healthcare providers have faced a new challenge since they must inform patients, provide care, accompany them, and implement the law. It also represents a new stumbling block at universities, which must adapt to regulatory changes and educate future professionals accordingly. Little is known about the attitude of nursing students in Spain toward euthanasia since this law was implemented. This study aims to answer the following research questions: What is the attitude of nursing students toward euthanasia? What factors influence this attitude? A cross-sectional study was conducted using an online questionnaire. The study population comprised all nursing students at a public university in Barcelona (n = 444), Spain, during the 2022-2023 academic year. The validated Spanish version of the Euthanasia Attitude Scale was employed. A bivariate analysis was performed. The university Ethics Committee (CEEAH 6247) approved this study. All participating students signed an informed consent form. Participation was voluntary, and data anonymity and confidentiality were guaranteed. Two hundred and forty-four nursing students responded to the questionnaire. The mean total score was 79.64. Participants with religious beliefs presented lower scores, indicating a more negative attitude toward euthanasia. Participants in their second, third, or fourth year of the nursing degree scored higher, demonstrating a more positive attitude. The attitude of nursing students toward euthanasia was remarkably positive. Working on ethical content during the degree course and clinical practice are factors that help to develop a more positive attitude. In addition, nursing education should encourage professional aspects to prevail over religious beliefs in euthanasia situations.

Rewilding in the British policy landscape. A qualitative analysis of policy documents related to rewilding

ABSTRACT UK parliamentary research recognises rewilding as an opportunity to fulfil national habitat restoration commitments. Nevertheless, there is a current lack of analysis concerning the policy landscape in Britain. To address this gap, we employ qualitative document analysis to assess how rewilding features in national policy documents in Britain. Using a structured search strategy to identify national policy documents from Scotland, England and Wales, we carry out inductive qualitative document analysis to inform a comparative study of the three nations. We find that despite a growing level of public interest in rewilding, and a proliferation of projects, rewilding remains poorly articulated in national policies. Definitional challenges and the impact of controversial rewilding practices influence if and how rewilding terminology features. We examine how different forms of engagement with rewilding at national level reflect divergent policy visions. We consider how the current level of policy engagement may influence the future implementation of rewilding in Britain and propose potential directions for future research in this field.

Maintaining an Aberrant Practice in a Contradictory Environment: The Case of Doping in Professional Road Cycling

AbstractSports doping is a practice that continues, despite hostile public opinion and counter‐efforts to close it down. In this paper we explore the maintenance of doping in the sport of professional road cycling. While studies of controversial practices find that they often benefit from levels of acceptance and even perceived value, we supplement such research by providing one of the few studies of practices that are subject to powerful social controls. In our case, the continual threat from anti‐doping organizations means that the maintenance and disruption of doping represents a kind of dialectical pair. We utilize and extend a model of types of institutional work that has advantages as an analytical tool, exploring the support required in this setting. Sustaining work was highly dynamic, relying on distinct groups within cycling teams to marshal organizational skills and cope with disruption, while repairing internal defences and concealing activities.

Hypnotherapy as a medical treatment: Evidence-based or pseudoscience?

BackgroundHypnotherapy continues to be a controversial practice in medicine. It is surrounded by myth and misuses that instill doubts about its legitimacy and usefulness. PurposeIn this paper, we will distinguish pseudoscientific claims from evidence-based uses of hypnotherapy. ResultsThe use and acceptability of hypnotherapy has varied over history. Pseudoscientific uses, based on outdated theories that it can access the unconscious mind, have delegitimized hypnotherapy. Modern theories that hypnosis uses common social, emotional, and cognitive processes combined with evidence-based methods have re-established the use of hypnotherapy in many physical and mental health disorders and symptoms. Currently it is a widely accepted and recommended treatment for irritable bowel syndrome, with evidence building for many other applications. ConclusionHypnotherapy, as a pseudoscience, can become unethical and cause distress for the patient and their families. Hypnotherapy, as an evidence-based treatment, can be used as a powerful tool to treat physical and psychological symptoms related to medical ailments.

Allopathic medicine practitioners' experiences with non-disclosure of traditional medicine use.

A pertinent issue impacting patient treatment outcomes is the nondisclosure of traditional medicine (TM) use to Allopathic medicine practitioners (AMPs). For years, TM has been a controversial practice, with patients often using it alongside allopathic medicine without disclosing their use. It is imperitive to learn and understand the experiences of AMPs regarding the disclosure of TM use in Gauteng province to enable them to provide the best possible treatment outcomes for patients who use TM. This study aimed to explore the experiences of AMPs regarding non-disclosure of TM use in Gauteng province. This study was conducted in four district hospitals where outpatient care and services are rendered in Gauteng Province. An interpretive phenomenological analysis (IPA) design was followed. Fourteen purposefully sampled AMPs participated in face-to-face, one-on-one, and semi-structured interviews. Interpretive phenomenological analysis in Atlas.ti was conducted. Three themes emerged: bedside manner of AMPs; stigmatising TM use; and individual belief systems. The belief of patients' disclosure hesitancy because of fear of judgment by the AMPs underpinned these themes. Allopathic medicine practitioners are aware that patients who use TM could feel guilty and stigmatised. They acknowledged that patients use TM because of cultural and ethnic reasons, which should not be disregarded. The study highlighted that patients do not disclose their TM use because of AMPs' attitudes, stigmatising TM use, and their prejudices against the cultural beliefs of patients. Allopathic medicine practitioners should establish good communication with patients by providing patient-centred communication to facilitate disclosure of TM use.