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They have no formal oversight authority. Practices regarding informed consent are inconsistent. This poses a major concern for patient safety while using CAM.
Complimentary and alternative medicine (CAM) has been criticized for a lack of standards in the delivery of services. Holexa and Caspi (2005) found that this lack of standards extends into the practice of informed consent. Patients often do not have access to proper information during the decision-making process. This increases the potential for healthcare oversights and mistakes.
When one examines informed consent issues, it is found that they are similar to the issues addressed in conventional therapies. The Ayurveda Healing Arts Institute (2008) has developed a set of informed consent and ethics that it requires member practitioners to follow. An examination of this article reveals that standards require full disclosure of evidence-based research regarding the procedure. It requires confidentiality of the procedure, professional courtesy, peer review and many other elements that are found in conventional medicine informed consent policies.
Literature regarding informed consent in the complementary and alternative medicine field is varied in terms of sources. A high degree of bias was found, even among credible academic journals. A majority of the sources were biased according to the views of the author regarding alternative medicine. Views ranged from supportive and willing to press for standardization to articles that highlight the lack of standardized testing for alternative medicine. The beliefs of the author were evident in every single source that was found on the topic.
The most prominent factor in this literature review was a lack of academic articles on informed consent and CAM in peer-reviewed journals. Many of the journals that had any information at all on informed consent and CAM were not found in mainstream medicine, but in journals within the alternative field. This demonstrates that CAM still has failed to find acceptance in mainstream medicine, regardless of a growing trend towards its use.
A lack of credible, primary resources from mainstream medical journals was the most obvious gap in literature regarding legal issues and CAM. The literature review may be improved through a more extensive internet search of practitioners in the field of CAM. Legal references may also be of help in future literature reviews, as many of the same legal issues apply to both mainstream and CAM.
Ayurveda Healing Arts Institute. 2008. Ayurvedic Herbalists Code of Ethics. [online] Available at http://www.ayurveda-california.com/ayurvedic_distance_education_berkeley/Buddhist_five_precepts/American_Herbalist_Guild_ethics.htm [Accessed March 26, 2008]. Primary source. Found by Google search.
Caspi, O. & Holexa, J. 2005. Lack of standards in informed consent in complementary and alternative medicine. Complementary Therapies in Medicine, 13 (2), 123-130. [online] Available at http://archinte.ama-assn.org/cgi/content/extract/161/19/2288 [Accessed March 26, 2008]. Primary Source. Science Direct Database online.
Drieman, B. 2006. Informed Consent. Journal of the American Dental Association, 137 (3),288. [online] Available at http://jada.ada.org/cgi/content/full/137/3/288-a?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1&FIRSTINDEX=0&minscore=5000&resourcetype=HWCIT.Secondary source. Found by searching "find similar articles in Jacobson article. [Accessed March 26, 2008].
Ernst, E. 2004. Balanced judgments on complementary/alternative medicine. Is informed consent necessary? Rheumatology 2004; 43 (5), 666. [online] Available at http://rheumatology.oxfordjournals.org/cgi/content/full/43/5/666 [Accessed March 26, 2008]. Primary Source: found through Google search.
Ernst, E. 2003. Regulation of complementary and alternative medicine. Focus Alternative and Complementary Therapies. 8, 291-2. [online] Available at http://www.medicinescomplete.com/journals/fact/current/fact0803a02t01.htm [Accessed March 26, 2008]. Primary source. Found by Google search.
Fan, E., Shabana, S., Praveen, K., Bienvenu, O., Mendez-Tellez, P., Pronovost, P., and Needham, D. 2008. Clinical Investigations. Critical Care Medicine. 36(1), 94-99. [online] Available at http://www.ccmjournal.com/pt/re/ccm/abstract.00-00013.htm;jsessionid=HqhVGC2ynjynpYhlTp1QPnF9NVHJHv2QvHZ82BnCBZq1GTlk3N5P!1675702673!181195628!8091!-1. [Accessed March 26, 2008]. Primary source. Found by Google search.
Hand-Boniakowski, J. 2007. Alternative Ethics. Metaphoria. April 29, 2007. 14 (8) 227. [online] Available at http://www.metaphoria.org/ac4t0704.html [Accessed March 26, 2008]. Primary source. Found by Google search.
Jacobsen, P. 2006. Local Anesthesia and Informed Consent. Journal of the American Dental Association, 137 (4), 436-437. [online] Available at http://www.asahq.org/Newsletters/2002/12_02/pracMgmt12_02.html [Accessed March 26, 2008]. Secondary source. Found through Google search for Informed consent
The Health Law Institute. 2003. Charting a Course: A Synthesis of Legal and Ethical Issues Relating to Complementary and Alternative Health Care (CAHC). [online] Available at http://www.hc-sc.gc.ca/dhp-mps/pubs/complement/cahc-acps_law-droit_synthes/cahc-acps_law-droit_synthes_e.html. [Accessed March 26, 2008]. Primary source. Found by Google search.[continue]
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