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Policy Perspectives
November 11, 1998

Physicians' Ethical Obligations Regarding Alternative Medicine

Author Affiliations

From the Division of General Internal Medicine (Dr Sugarman), Center for the Study of Aging and Human Development (Dr Sugarman), and the Departments of Philosophy (Dr Sugarman), Radiology (Dr Burk), and Office of Integrative Medicine Education (Dr Burk), Duke University, Durham, NC.

JAMA. 1998;280(18):1623-1625. doi:10.1001/jama.280.18.1623

A SUBSTANTIAL proportion of patients use alternative medicine, spending an estimated $13 billion each year.1-3 Complementary and alternative medicine incorporates "all health systems, modalities, and practices other than those intrinsic to the politically dominant health system of a particular society or culture" and "includes all practices and ideas self-defined by their users as preventing or treating illness or promoting health and well-being."4 Under this definition, the scope of professional obligations regarding alternative medicine for clinicians who provide conventional medical care is unclear. Despite the popularity of alternative medicine, conventional medicine is arguably the politically dominant health system with a somewhat circumscribed set of practices that differ from alternative therapies. However, given the strong professional obligations clinicians have toward helping patients meet health-related goals, the scope of these obligations with respect to alternative medicine deserves discussion.