Volume 11, Number 3, November 2000

Editor's Forum

Vangie Bergum, RN PhD
Professor, Faculty of Nursing
Director, John Dossetor Health Ethics Centre
University of Alberta

Paul Byrne, MB, ChB, FRCPC
Staff Neonatologist, Stollery Children's Health Centre
Associate Director, Clinical Ethics, John Dossetor Health Ethics Centre, University of Alberta

This issue of Health Ethics Today focuses on the subject of health care practice delivery, which lies "outside the mainstream". The term alternate medicine (and more recently, complementary medicine) has been used to describe a variety of approaches to treatment and diagnosis which do not use the (Orthodox) medical-science based model of disease for clinical practice. The term alternative medicine suggests that the science based physiology disease focused approach is the primary mode of diagnosis and treatment of health problems.

Medical and nursing students are taught in highly structured science based curricula with uniform standards and expectations across schools. Practitioners are expected to practice within a strictly regulated profession with clearly documented standards to be met by all those certified to practice. Similar standards apply to a wide variety of health care practitioners (HCPs) including physical therapists, occupational therapists, speech therapists, social workers, etc.

Over the past two decades a growing percentage of the population in Canada has become somewhat disenchanted with the medical profession and with the medical model of health care delivery. Large numbers of individuals use the services of health practitioners who promote "a different understanding" of health and illness and who base therapy on this understanding. Therapies ranging from acupuncture and aromatherapy to Moxibustion and herbal remedies are being embraced by many more individuals than was the case twenty years ago. Editorials in prominent medical journals have noted this trend. Wide acceptance by the public of these therapies as beneficial has resulted in more attention by researchers and medical practitioners into the basis of their effects.

A great deal of controversy has been generated as a result of claims and counterclaims about the validity of these alternative-complementary therapies. There continues to be an atmosphere of suspicion on the part of many physicians about alternative therapy. Similar suspicions about the true benefits and risks of mainstream medical therapy also exist among alternative medical practitioners who point to the lack of evidence to support the supposed efficiency of many standard medical and surgical treatments.

An integral part of ethics is dialogue. In this issue of Health Ethics Today, we attempt to open up a constructive dialogue among those who provide a broad range of therapies. We believe that mutual respect for each other's expertise and skill is a good starting point from which to make progress in our collective understanding of health and illness.

We welcome your thoughts on any article you read in this issue, and past issues, of Health Ethics Today and encourage you to write to us. Letters to the Editorial Committee will be considered for publication in upcoming issues of Health Ethics Today.