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eCAM Advance Access published online on April 17, 2009
eCAM, doi:10.1093/ecam/nep032
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© 2009 The Author(s).
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.0/uk/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Informed Consent in Complementary and Alternative Medicine

Opher Caspi1, Tamar Shalom2 and Joshua Holexa3

1Integrative Medicine Unit, Rabin Medical Center and the Tel-Aviv University, 2Department of Health System Management, Ben-Gurion University, Israel and 3Department of Emergency Medicine, University Medical Center, Tucson, AZ, USA

The objective of this study was to examine complementary and alternative medicine (CAM) practitioners’ (i) attitudes toward informed consent and (ii) to assess whether standards of practice exist with respect to informed consent, and what these standards look like. The design and setting of the study constituted face-to-face qualitative interviews with 28 non-MD, community-based providers representing 11 different CAM therapeutic modalities. It was found that there is great deal of variability with respect to the informed consent process in CAM across providers and modalities. No unique profession-based patterns were identified. The content analysis yielded five major categories related to (i) general attitude towards the informed consent process, (ii) type and amount of information exchange during that process, (iii) disclosure of risks, (iv) discussions of alternatives, and (v) potential benefits. There is a widespread lack of standards with respect to the practice of informed consent across a broad range of CAM modalities. Addressing this problem requires concerted and systematic educational, ethical and judicial remedial actions. Informed consent, which is often viewed as a pervasive obligation is medicine, must be reshaped to have therapeutic value. Acknowledging current conceptions and misconception surrounding the practice of informed consent may help to bring about this change. More translational research is needed to guide this process.

Keywords: complementary and alternative medicine – informed consent – medical ethics – decision-making – public health

For reprints and all correspondence: Opher Caspi, Director, Integrative Medicine, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel 49100, Israel. Tel: +972-3-9377946; Fax: +972-3-9377974; E-mail: ophercaspi{at}gmail.com

Received October 14, 2008; accepted March 3, 2009


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