Parens Patriae and Parental Rights: When Should the State Override Parental Medical Decisions?

Alfie Evans was a terminally ill British child whose parents, clinging to hope, were desperately trying to save his life. Hospital authorities disagreed and petitioned the court to enjoin the parents from removing him and taking him elsewhere for treatment. The court stepped in and compelled the hospital to discontinue life support and claimed that further treatment was not in the child's best interest. This note discusses the heartbreaking stories of Alfie and two other children whose parents' medical decisions on their behalf were overridden by the court. It argues that courts should never decide that death is in a child's best interest and compel parents to withdraw life support from their children. Such a decision is outside the scope of the judiciary. Furthermore, it argues that even in those instances when the court may or must intervene, a new framework is necessary because the current framework used by the court to determine the best interest of the child ignores fundamental realities of child psychology. Too often, as a result of the court's mistaken framework, the court illegitimately trespasses into the parental domain. By adopting a new framework, the court will intervene only when actual abuse or neglect is suspected. In all other cases, judicial restraint will be practiced and the court will show greater deference to the parents' wishes.

"Accept and Utilize": Alternative Medicine, Minimality, and Ethics in an Indonesian Healing Collective.

Cosmopolitan forms of alternative medicine have become very popular in contemporary Indonesia. Many healers have trained in an eclectic range of techniques, predicated on ontological claims so diverse that they call each other's legitimacy into question. This article explores how a collective of alternative healers in central Java navigated the quandaries presented by such therapeutic eclecticism over a six-year period. Healers' engagement with, or indifference toward, the principles underpinning therapeutic efficacy fluctuated in ways that allowed them to surmount the dilemmas of Islamization, the changing demographic of their collective's membership, and the threat of commercialization, thereby maintaining a medical landscape in which alternative healing was widely available and accessible. Transformations in their understanding, experience, and practice of healing should thus be understood in terms of how enduring ethical commitments are refracted through ongoing engagements with a changing social world.

Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review.

OBJECTIVE: The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines. METHODS: International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists' practices or perceptions, consumers' expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists' responsibilities in selling complementary medicines were included in the review. KEY FINDINGS: Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist's business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict. CONCLUSION: There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines.

Toward an Explanatory Framework for Yoga Therapy Informed by Philosophical and Ethical Perspectives.

Context • Yoga Therapy is an emerging complementary and integrative health practice for which there is increasing interest from both clinical and research perspectives. Currently missing, however, is an explanatory framework for the profession that provides practitioners, clients, and the public with an understanding of how various yogic traditions and principles can be understood in modern health care contexts. Objective • This study proposes an explanatory framework for yoga therapy, informed by phenomenology, eudaimonia, virtue ethics, and first-person ethical inquiry. Conclusions • These 4 philosophical perspectives-phenomenology, eudaimonia, virtue ethics, and first-person ethical inquiry-provide a lens through which to understand how yogic practices support the individual's transformation in the experience of illness, pain, or disability. We propose that this transformation occurs through facilitating a reharmonization of body, mind, and environment toward the experience of eudaimonic well-being.

Responsabilidad, ciencia y evidencia frente a las pseudoterapias / No disponible

No disponible

Pediatric Integrative Medicine.

The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to this mission, the American Academy of Pediatrics recognizes the increasing use of complementary and integrative therapies for children and the subsequent need to provide reliable information and high-quality clinical resources to support pediatricians. This Clinical Report serves as an update to the original 2008 statement on complementary medicine. The range of complementary therapies is both extensive and diverse. Therefore, in-depth discussion of each therapy or product is beyond the scope of this report. Instead, our intentions are to define terms; describe epidemiology of use; outline common types of complementary therapies; review medicolegal, ethical, and research implications; review education and training for select providers of complementary therapies; provide educational resources; and suggest communication strategies for discussing complementary therapies with patients and families.

Non-conventional practice versus evidence-based medicine. A scientific and ethical analysis of the Italian regulation.

BACKGROUND: The current lack of scientific validation of non-conventional treatments in medicine, whose epistemological foundations lie in scientific evidence and experimentation, raises significant questions regarding the costs and benefits of alternative-treatment forms. Nonetheless, in the last few decades non-conventional treatments have been increasingly recognised by the Italian medical profession, with one regional healthcare administration adopting some non-conventional practices as part of its conventional healthcare services. AIMS: The Authors aim to analyse non-conventional treatments in medicine from an epistemological, cultural, ethical, political and economic point of view, in order to highlight criticalities and incongruities, especially when these treatments are approved by a public healthcare system, which should be grounded on the "evidence-based medicine" principle. CONCLUSIONS: Non-conventional treatments in medicine are constituted by meta-theories, i.e. philosophical, religious and ideological concepts that conflict with contemporary rational, empirical medicine. In the interest of patients and society, the paper stresses the incongruity of a healthcare system which, despite being grounded on the "evidence-based medicine" principle, allows the development of non conventional treatments. Having said that, medical science should address not only the biological domain of illness but also its existential implications. Awareness and respect for the individual experience can undoubtedly lead to a new medical model that allows for a more effective therapeutic intervention.

Código de Ética Profissional do Naturólogo / Code of Ethics for the Naturology Profession

O presente Código de Ética Profissional se aplica a todo bacharel em Naturologia atuante no Brasil e tem como objetivo apresentar os princípios éticos norteadores, além de direitos e deveres no exercício de sua profissão.(AU)

Princípios centrais da relação de interagência: uma contribuição para a clínica naturológica / Core principles of the interaction's relationship: a contribution to the naturological clinical practice

Introdução: A Naturologia é um conhecimento que preconiza uma visão ampliada dos processos de saúde e oferece uma perspectiva de promoção e educação para a saúde. Tem sua origem no Brasil nos mesmos movimentos que consolidaram a Naturopatia neste país e no mundo, e suas especificidades são o diálogo entre as racionalidades de saúde como proposta epistemológica e a Relação de Interagência. Relação de Interagência é o nome dado à relação terapêutica na Naturologia. Objetivo: Revisar a literatura sobre a Relação de Interagência para identificar, sumarizar, sistematizar e discutir os princípios centrais que a norteiam, sob uma perspectiva clínica. Percurso metodológico: Foi realizada uma revisão narrativa da literatura, e os achados sobre a Relação de Interagência foram dialogados com saberes de outras áreas. Desenvolvimento: Dentre diversos conceitos citados como norteadores da Relação de Interagência na literatura disponível, 5 princípios centrais foram destacados para fins de sintetização: presença; empatia; integralidade; autonomia; e corresponsabilidade. Estes princípios são apresentados e discutidos ao longo do artigo, e foram feitos apontamentos de aplicação prática quando pertinente.(AU)

Introduction: Naturology is a knowledge that advoctes an enlarged understanding of health processes and a perspective of health promotion and education. Its origins in Brazil are the same movements that have consolidated Naturopathy in this country and in the world. Some specificities are the dialogue between health rationalities as an epistemological proposal and interaction´s relationship. "Interaction´s Relationship". is tha name given to the therapeutic relationship in Naturology. Objective: To review the literature on Interaction´s Relationship and to identify, summarize, systematize and discuss the core principles that guide it from a clinical perspective. Methodological route: A narrative revil of the literature was carried ou, and the findings on an Interaction´s Relationship with dialogues with knowledge from other areas. Development: Among several concepts cited as guiding principles of the Interaction´s Relationship in the literature, five core prominent principles were highlighted for synthesizing purposes: presence; empathy; wholeness; autonomy; and co-responsbility. These core principles were discussed throughout the paper and practical considerations were made.(AU)

Complementary and Alternative Medicine in the Context of Earlier Diagnoses of Alzheimer's Disease: Opening the Conversation to Prepare Ethical Responses.

Preclinical Alzheimer's disease (AD), a newly proposed, actively researched, and hotly debated research-only diagnostic category, raises the prospect of an ethical dilemma: whether, and possibly how, to treat a disorder with no target symptoms. This proposed category rests on the detection of a number of biomarkers thought to provide evidence of AD pathophysiology years before any behavioral symptoms manifest. Faced with limited treatment options, patients and their relatives may come to consider complementary and alternative medicine (CAM) a viable option, albeit one with minimal supporting evidence. Accordingly, the hopes and needs of some preclinical patients and their relatives could further fuel market-oriented entrepreneurship for CAM. In this ethics review, we provide background and reflect on some ethical questions related to the roles of key stakeholders arising from the potential for CAM use in the context of a possible preclinical AD diagnosis.

No Understanding, No Consent: The Case Against Alternative Medicine.

The demand for informed consent in clinical medicine is usually justified on the basis that it promotes patient autonomy. In this article I argue that the most effective way to promote autonomy is to improve patient understanding in order to reduce the epistemic disparity between patient and medical professional. Informed consent therefore derives its moral value from its capacity to reduce inequalities of power as they derive from epistemic inequalities. So in order for a patient to have given informed consent, she must understand the treatment. I take this to mean that she has sufficient knowledge of its causal mechanisms and has accepted the explanations in which the treatment is implicated. If this interpretation of informed consent is correct, it is unethical for medical professionals to offer or endorse 'alternative medicine' treatments, for which there is no known causal mechanism, for if they do, they may end up widening the epistemic disparity. In this way, informed consent may be understood as an effective way of ruling out particular treatments in order to improve patient autonomy and maintain trust in the medical profession.

Alternative Medicine and the Ethics Of Commerce.

Is it ethical to market complementary and alternative medicines? Complementary and alternative medicines (CAM) are medical products and services outside the mainstream of medical practice. But they 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 CAM. 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 the ethics of selling CAM.