Physicians' Ethical obligations to Patients.

• Position: Brief Article

Even doctors who subscribe to only conventional medical therapies have an ethical obligation to help their patients who are considering non-traditional treatments, maintain two physicians at Duke University Medical Center, Durham, N.C. Medical ethicist Jeremy Sugarman and Larry Burk, director of the Office of Integrative Medicine Education, emphasize that clinicians' obligations regarding alternative medicine center on whether those therapies have been shown through rigorous examination to be safe and effective. If the therapies are not tested and proven, doctors do not have the same obligation.

They argue that it is important to examine the principles of care common to both conventional and alternative treatment. Clinicians following conventional medicine rely on scientific methods in making decisions about appropriate therapy, while practitioners of alternative medical treatments, such as acupuncture and therapeutic touch, generally do not. The health-related goals of the two approaches may not differ radically, though. For instance, both promote prevention of illness and relief of pain or suffering.

The first principle to consider is the patients' right to be informed so they can make the best decisions regarding their treatment. While clinicians' knowledge of an alternative medicine may not be expansive, they are obligated to help patients understand issues of the safety of treatments and how to get more information on options that they may be considering.

"It may be easier for clinicians to accept a patient's choice of alternative therapy if there are no known effective conventional ways to treat a condition. And there are cases when we would be remiss as physicians if we didn't counsel a patient to avoid alternative...