“The Best of Both Worlds”: Principles for Allopathic Clinicians with Patients Seeking Complementary and Alternative Medicine

Abstract: Many patients who are seeking allopathic treatment, sometimes also known as mainstream or conventional medical treatment, also choose to seek complimentary and alternative medical treatment (CAM), based on philosophical, practical, ontological, or spiritual commitments that there will be benefits from both options. This means that allopathic clinicians may be treating patients who are also seeking treatment using modalities that they are not familiar with. It is not realistic to expect all clinicians to have the time or the ability to become intimately familiar with all possible CAM treatments patients may be utilizing. However, patients seeking CAM are vulnerable in unique ways to harm both inside and outside of the allopathic clinical relationship. How then can clinicians appropriately care for their patients seeking CAM in a way that protects their patient’s health, the relationship between patient and clinician, and the clinician’s professional obligations and identity? How can we tell when collaboration on overlapping treatments with CAM providers may be necessary, and what should guide this collaboration? Informed by experiences in providing clinical ethics support to allopathic clinicians in this situation in [statename], an area with a high rate of patients seeking concurrent CAM treatment, and a goal to take CAM treatment seriously within its own framework while recognizing the limits of allopathic clinician’s knowledge and professional obligations, I will present a series of principles for clinical encounters with patients seeking CAM. I will then provide clinical ethics case studies to expand on these principles, and to highlight tensions which remain.

Keywords: Alternative medicine, Clinical ethics