Alternative Medicine and the Ethics Of Commerce

[HuckleB]

http://onlinelibrary.wiley.com/doi/10.1111/bioe.12226/full

"Is it ethical to produce and market complementary and alternative medicines? Complementary and alternative medicines (CAM) are medical products and services outside the mainstream of medical practice. As the terms imply, ‘complementary’ medicines are typically offered as an adjunct to other, more mainstream, treatments, whereas ‘alternative’ medicines are offered as substitutes for mainstream treatments. It is important to emphasize that complementary and alternative medicines are not just medicines (or supposed medicines) offered and provided for the prevention and treatment of illness. They are also products and services – things offered for sale in the marketplace. Most discussion of the ethics of CAM has focused on bioethical issues – issues having to do with therapeutic value, and the relationship between patients and those purveyors of CAM1. This article aims instead to consider CAM from the perspective of commercial ethics. That is, we consider the ethics not of prescribing or administering CAM (activities most closely associated with health professionals) but with the ethics of selling CAM (something that may be done by profit-oriented health professionals, or by retail outlets). Our interest here includes all commercial activities focused on CAM. It includes, for example, manufacturers of all types, whether major pharmaceutical company or small producer of, for example, homeopathic remedies. And it includes all kinds of providers, whether that provider is a health professional such as a physician or a pharmacist, or instead a specialized purveyor of CAM, for example a homeopath or a naturopath, members of occupations that hold themselves out, at least, as health professionals.

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Consider also the case of CAM remedies derived from species (such as the rhinoceros) that are being driven extinct because of demand for animal parts based on magical thinking.14 In such cases, our shared ecological heritage is being diminished by an industry that pursues exotic – and generally useless – ingredients. In such cases, CAM again violates the ethical principle that forbids participants in a commercial transaction from imposing harms on unconsenting third parties.

As a final category of the marketing of CAM having a significant impact on third parties, consider the tragic cases in which parents fail to provide adequate care to their children because they insist on providing CAM instead. Examples abound, unfortunately, and many have resulted in criminal charges and have thus found their way into the media. An Australian couple, for example, were found guilty of manslaughter as a result of having treating their infant daughter's eczema with homeopathy, rather than with any of the conventional treatments that could easily have prevented her death.15 A Canadian mother faced criminal charges in the death of her son after she opted for treating his serious strep infection with various forms of CAM, including herbal therapy, rather than taking him to a physician who would likely have prescribed an easy and effective course of antibiotics.16

Conclusion:

Central cases of CAM can be shown to violate all three of the fundamental principles presented above. We conclude that there are significant ethical problems, from the perspective of the ethics of commerce, with the production, advertising and selling of complementary and alternative medicines. The ethics of commerce is generally relatively permissive. Commercial acts between consenting adults are generally free from substantial third party critique. Markets function well, and do well at satisfying human needs, when we allow market participants substantial freedom to innovate and to engage in exchanges even when we ourselves do not endorse those exchanges, or even understand their desirability. But there are ethical limits to market interactions. Market interactions, in order to be considered ethical, need to involve products that actually work, that are advertised honestly, and that do not have undue effects on innocent third parties. Many examples of CAM fail on one or even all of those counts.

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Worth the read, IMO.