The ethical issues and conflicts of interest that are faced by the TCM practitio

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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