Assuntos
Anestesiologia/ética , Tomada de Decisões/ética , Prestação Integrada de Cuidados de Saúde/ética , Difusão de Inovações , Letramento em Saúde/ética , Futilidade Médica/ética , Assistência Centrada no Paciente/ética , Assistência Perioperatória/ética , Anestesiologia/organização & administração , Anestesiologia/normas , Prestação Integrada de Cuidados de Saúde/organização & administração , Prestação Integrada de Cuidados de Saúde/normas , Conhecimentos, Atitudes e Prática em Saúde , Disparidades em Assistência à Saúde/ética , Humanos , Modelos Organizacionais , Educação de Pacientes como Assunto/ética , Participação do Paciente , Assistência Centrada no Paciente/organização & administração , Assistência Centrada no Paciente/normas , Assistência Perioperatória/normasRESUMO
Due to new offers in prenatal diagnostics pregnant women are forced to make choices. In Switzerland physicians are obliged to inform previous to prenatal tests and to obtain informed consent. Considering the complexity of this information and the consequences of a positive result, counselling is challenging, especially in an intercultural context. A questionnaire-based study compared information processing, test interpretation and emotional response of pregnant women from Switzerland and adjacent countries with Turkish women. Knowledge of the latter was significantly lower and they found counselling more unsettling, but their acceptance of prenatal tests was significantly higher. An empathetic approach and the right words are decisive, and counselling will even gain importance when considering the increase in options patients are confronted with.
Les nouvelles offres dans le diagnostic prénatal contraignent les femmes enceintes à faire des choix. En Suisse, les médecins ont le devoir d'informer au sujet des tests prénataux et en obtenir le consentement. Compte tenu de la complexité, ce conseil est exigeant, avant tout dans un contexte interculturel. Une étude basée sur des questionnaires a comparé les connaissances et les réactions émotionnelles des femmes enceintes de Suisse avec des femmes venant de la Turquie. Cela a montré que les connaissances de ces dernières étaient moindres et qu'elles se sentaient plus insécurisées tout en montrant une acceptation significativement plus élevée relativement au diagnostic prénatal. Une attitude empathique et des mots bien choisis sont décisifs et leur importance va encore prendre de l'ampleur avec l'augmentation des options à disposition des patientes.
Assuntos
Educação de Pacientes como Assunto , Diagnóstico Pré-Natal , Aborto Eugênico/ética , Aborto Eugênico/psicologia , Emigrantes e Imigrantes/educação , Emigrantes e Imigrantes/psicologia , Ética Médica , Feminino , Maternidades , Hospitais Universitários , Humanos , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/psicologia , Cobertura do Seguro/economia , Programas Nacionais de Saúde/economia , Educação de Pacientes como Assunto/ética , Gravidez , Diagnóstico Pré-Natal/economia , Diagnóstico Pré-Natal/ética , Diagnóstico Pré-Natal/psicologia , Suíça , Turquia/etnologiaRESUMO
BACKGROUND: The increasing demand for complementary and alternative medicine (CAM) raises ethical questions about specific aspects of both CAM and conventional medicine (COM). METHODS: The present article provides a critical survey of the most important ethical aspects in the current debate about CAM. RESULTS: The relevant ethical issues arise mainly in 4 main areas: 1) patient information, 2) research ethics, 3) cost, and 4) education. Most of the contributions used for our purpose are based upon the implicit assumption that, in principle, the ethics of CAM and COM have to be identical because of the same underlying doctor-patient relationship. This premise is shared by the author. CONCLUSIONS: Substantial efforts on various levels will have to be made in order to create the conditions necessary for CAM to be ethically justified. But the ethical implications for COM also have to be considered.
Assuntos
Terapias Complementares/ética , Terapias Complementares/estatística & dados numéricos , Ética Médica , Beneficência , Competência Clínica , Terapias Complementares/economia , Análise Custo-Benefício/economia , Aprovação de Drogas , Educação Médica , Alemanha , Homeopatia/economia , Homeopatia/ética , Humanos , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/ética , Educação de Pacientes como Assunto/economia , Educação de Pacientes como Assunto/ética , Relações Médico-Paciente/ética , Fitoterapia/economia , Fitoterapia/ética , Resultado do TratamentoRESUMO
This article describes a method of moral counselling developed in the Radboud University Medical Centre Nijmegen (The Netherlands). The authors apply insights of Paul Ricoeur to the non-directive counselling method of Carl Rogers in their work of coaching patients with moral problems in health care. The developed method was shared with other health care professionals in a training course. Experiences in the course and further practice led to further improvement of the method.
Assuntos
Aconselhamento/métodos , Ética Profissional , Educação de Pacientes como Assunto/ética , Autonomia Pessoal , Padrões de Prática Médica/ética , Relações Profissional-Paciente/ética , Espiritualidade , Adaptação Psicológica , Humanos , Princípios Morais , Motivação , Países Baixos , Cooperação do Paciente , Educação de Pacientes como Assunto/métodos , Papel Profissional , Avaliação de Programas e Projetos de SaúdeRESUMO
Beyond its interest in the field of public health and the political aspect with the "Hospital, patients, health and territories" law, therapeutic education now occupies an important place in nursing care. This new nursing culture provides another clinical approach for the nurse and a real means of learning for the patient in the framework of a support and guidance plan drawn up together.
Assuntos
Papel do Profissional de Enfermagem , Educação de Pacientes como Assunto , Participação do Paciente , França , Regulamentação Governamental , Política de Saúde/legislação & jurisprudência , Humanos , Programas Nacionais de Saúde/ética , Programas Nacionais de Saúde/organização & administração , Planejamento de Assistência ao Paciente/ética , Planejamento de Assistência ao Paciente/organização & administração , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/organização & administração , Participação do Paciente/legislação & jurisprudência , Participação do Paciente/métodos , Autocuidado/éticaRESUMO
BACKGROUND: Beta thalassemia major is a severe inherited form of hemolytic anemia that results from ineffective erythropoiesis. Allogenic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative therapy. Unfortunately, the subgroup of adult thalassemia patients with hepatomegaly, portal fibrosis and a history of irregular iron chelation have an elevated risk for transplantation-related mortality that is currently estimated to be about 29 percent. DISCUSSION: Thalassemia patients may be faced with a difficult choice: they can either continue conventional transfusion and iron chelation therapy or accept the high mortality risk of HSCT in the hope of obtaining complete recovery.Throughout the decision making process, every effort should be made to sustain and enhance autonomous choice. The concept of conscious consent becomes particularly important. The patient must be made fully aware of the favourable and adverse outcomes of HSCT. Although it is the physician's duty to illustrate the possibility of completely restoring health, considerable emphasis should be put on the adverse effects of the procedure. The physician also needs to decide whether the patient is eligible for HSCT according to the "rule of descending order". The patient must be given full details on self-care and fundamental lifestyle changes and be fully aware that he/she will be partly responsible for the outcome. SUMMARY: Only if all the aforesaid conditions are satisfied can it be considered reasonable to propose unrelated HSCT as a potential cure for high risk thalassemia patients.
Assuntos
Beneficência , Tomada de Decisões/ética , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas/ética , Transplante de Células-Tronco Hematopoéticas/mortalidade , Consentimento Livre e Esclarecido/ética , Seleção de Pacientes/ética , Pacientes/psicologia , Autonomia Pessoal , Talassemia beta/terapia , Adulto , Transfusão de Sangue , Terapia por Quelação , Comportamento de Escolha/ética , Compreensão , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Ferro , Julgamento , Estilo de Vida , Motivação , Educação de Pacientes como Assunto/ética , Resolução de Problemas , Qualidade de Vida , Autocuidado , Taxa de Sobrevida , Transplante Homólogo/mortalidade , Revelação da Verdade/ética , Talassemia beta/fisiopatologia , Talassemia beta/cirurgiaRESUMO
OBJECTIVE: To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. SETTING: The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. METHODS: A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. RESULTS: The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. CONCLUSION: The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the sustainability of cognitive services.
Assuntos
Atenção à Saúde/métodos , Estudos de Casos Organizacionais , Educação de Pacientes como Assunto , Assistência Farmacêutica/organização & administração , Farmácias/organização & administração , Projetos de Pesquisa , Dinamarca , Ética Farmacêutica , Implementação de Plano de Saúde , Humanos , Reembolso de Seguro de Saúde , Liderança , Programas Nacionais de Saúde , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/organização & administração , Assistência Farmacêutica/normas , Projetos Piloto , Competência Profissional , Controle de Qualidade , Indicadores de Qualidade em Assistência à SaúdeRESUMO
All healthcare providers decide in someone else's place, for someone else. In doing so, they take their place in a long long tradition, that of medical paternalism. Patients are treated as children, incapable of making decisions about themselves. How then are we supposed to deal with patients like the street children of the Democratic Republic of the Congo, who are not part of our health-care system, who refuse care and prescriptions? Their refusal of caregivers forces us to seek strategies to dispel the conflicts, adapt outselves to the situation (self-medication, drug sales outside of dispensaries, etc.), but especially to rethink the relation between caregivers and patients. This does not mean abandoning the authoritarian patriarchal model for total relativism; the use of drugs such as antibiotics is and must remain surrounded by all the precautions necessary to avoid the further development of resistance; it does mean training and informing. The task facing us is that of health education and promotion, a long and continuous process, centered on patients and integrated with their care, aimed at making them capable of managing their disease. This procedure is part of a pragmatic approach: beyond the asymmetry involved in any relationship of power, it is essential to establish informed confidence, to look for adhesion and not constraint. Only this pragmatism can incite young people with sexually transmitted diseases (STDs) to use modern medicine and comply with the dosage instructions. Effective treatment of STDs is, according to WHO, one of the most powerful weapons in the battle against AIDS transmission.
Assuntos
Antibacterianos/administração & dosagem , Jovens em Situação de Rua , Educação de Pacientes como Assunto , Doenças Bacterianas Sexualmente Transmissíveis/tratamento farmacológico , Adolescente , Criança , República Democrática do Congo , Feminino , Humanos , Masculino , Educação de Pacientes como Assunto/ética , AutoadministraçãoRESUMO
Talking to patients from diverse cultural backgrounds about their psychiatric disorders requires knowledge of one's own culture, the patients' cultures, and the ways in which they might interact, both in positive and unexpectedly negative ways. In this paper, we discuss the issues raised by discussing psychiatric diagnoses with Chinese-Americans who hold traditional illness beliefs and are not familiar with Western conceptions of psychiatric disorders. We explore how cultural values influence this aspect of medical practice, and suggest practical approaches to communicating the diagnosis of major depressive disorder in a culturally sensitive manner. Our clinical approach is to develop co-constructed illness narratives with patients, and to aid this process by reframing different elements of the clinical process into more culturally resonant forms. The following steps are suggested: 1) elicit patient's illness beliefs; 2) understand and acknowledge multiple explanatory models; 3) contextualize depressive symptoms into patient's physical health and social system; 4) introduce Western psychiatric theories in ways that reflect assumptions shared by Traditional Chinese Medicine (TCM); 5) involve patients' families whenever possible; and 6) use terminology that avoids unintended stigma.
Assuntos
Aculturação , Asiático/psicologia , Comunicação , Transtorno Depressivo Maior/etnologia , Ética Médica , Psiquiatria/ética , Asiático/etnologia , Competência Cultural/ética , Competência Cultural/psicologia , Cultura , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/parasitologia , Humanos , Medicina Tradicional Chinesa/psicologia , Educação de Pacientes como Assunto/ética , Relações Médico-Paciente/ética , Papel do Doente/ética , Valores SociaisRESUMO
Religious beliefs and the use of complementary and alternative medicine can help or hinder health care and the well being of children, who are often unable to make informed decisions for themselves, but instead, depend on their parents or caregivers to make health care decisions for them. Tragically, this can sometimes result in prolonged suffering and death when parents or caregivers refuse treatment due to their own personal beliefs. This two-part article explores the case of Kara Neumann, an 11-year-old girl who died after her parents denied her medical care in lieu of prayer to cure her "spiritual attack," and the role pediatric nurses can play in educating patients and their families.
Assuntos
Defesa da Criança e do Adolescente/ética , Consentimento dos Pais/ética , Ética Baseada em Princípios , Religião , Recusa do Paciente ao Tratamento/ética , Criança , Defesa da Criança e do Adolescente/legislação & jurisprudência , Defesa da Criança e do Adolescente/psicologia , Cuidado da Criança/ética , Cuidado da Criança/legislação & jurisprudência , Cuidado da Criança/psicologia , Cristianismo/psicologia , Cetoacidose Diabética/prevenção & controle , Evolução Fatal , Feminino , Liberdade , Homicídio/ética , Homicídio/legislação & jurisprudência , Homicídio/psicologia , Humanos , Papel do Profissional de Enfermagem , Consentimento dos Pais/legislação & jurisprudência , Consentimento dos Pais/psicologia , Pais/educação , Pais/psicologia , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/organização & administração , Enfermagem Pediátrica/ética , Enfermagem Pediátrica/organização & administração , Religião e Psicologia , Recusa do Paciente ao Tratamento/legislação & jurisprudência , Recusa do Paciente ao Tratamento/psicologia , Estados UnidosRESUMO
The treatment of pelvic floor disorders using biofeedback, behavioral therapies, and other applied psychophysiological treatments has been well documented as effective. Practitioners must take due care to ensure that they practice within the boundaries of what is common practice for their discipline and within the scope of practice allowed by their professional license as outlined by the appropriate state licensing law(s), the ethical principles and practice guidelines and standards for their discipline, and those of the Association of Applied Psychophysiology and Biofeedback if using a biofeedback assessment or treatment. Being competent to provide a particular treatment does not necessarily make it legal and/or ethical. This paper provides a set of recommended practice guidelines for use in the assessment and treatment of pelvic floor disorders. Please note that they have not at this time been endorsed as an official position of the Association of Applied Psychophysiology and Biofeedback or any other professional organization.
Assuntos
Doenças do Ânus/terapia , Biorretroalimentação Psicológica/ética , Terapia Cognitivo-Comportamental/ética , Ética Profissional , Diafragma da Pelve , Doenças Retais/terapia , Doenças Urológicas/terapia , Doenças do Ânus/diagnóstico , Doenças do Ânus/etiologia , Terapia Combinada , Prática Clínica Baseada em Evidências , Humanos , Consentimento Livre e Esclarecido/ética , Capacitação em Serviço , Educação de Pacientes como Assunto/ética , Privacidade , Competência Profissional , Relações Profissional-Paciente , Doenças Retais/diagnóstico , Doenças Retais/etiologia , Encaminhamento e Consulta/ética , Doenças Urológicas/diagnóstico , Doenças Urológicas/etiologiaRESUMO
No disponible
The Joslin Clinic has more than eighty years of experience in providing high-quality nutrition care and education to its patients. A widevariety of educational programs, classes, and individual appointmentsare available to patients in order to improve their nutrition and diabetesself-care knowledge. Nutrition care follows the guidelines of theAmerican Diabetes Association as well as the Joslin Diabetes CentersClinical Nutrition Guidelines. Nutrition professionals in the clinicutilize innovative educational methods tailored to the medication regimensand individual characteristics of the patients to help them optimize their eating patterns and meal planning (AU)
Assuntos
Educação de Pacientes como Assunto/métodos , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/psicologia , 52503/educação , Insulina/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto/classificação , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/tendências , Vigilância Alimentar e Nutricional/métodos , Serviço Hospitalar de Educação/normas , Educação Alimentar e Nutricional , Educação de Pacientes como Assunto/éticaRESUMO
Procedures of Informed Consent are considered a high priority for international biomedical research. However, informed consent protocols are not necessarily transferable across cultural, national or ethnic groups. Recent debates identify the need for balancing ethical universals with practical and local conditions and paying attention to questions of cultural competence when it comes to the Informed Consent process for clinical biomedical research. This article reports on the results of a two-year effort to establish a culturally appropriate Informed Consent process for biomedical research in the Tibet Autonomous Region in the People's Republic of China. A team of Tibetan and American researchers, physicians, health professionals and medical anthropologists conducted the research. The Informed Consent was specifically for undertaking a triple-blind, double placebo-controlled randomized clinical trial of a Tibetan medicine compared with Misoprostol for reducing postpartum blood loss. The findings suggest greater need for flexibility and cooperation in establishing Informed Consent protocols across cultures and nations.
Assuntos
Comparação Transcultural , Competência Cultural/ética , Consentimento Livre e Esclarecido/ética , Medicina Tradicional Tibetana , Misoprostol/uso terapêutico , Ocitócicos/uso terapêutico , Hemorragia Pós-Parto/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto/ética , Cultura , Feminino , Humanos , Recém-Nascido , Idioma , Educação de Pacientes como Assunto/ética , Gravidez , TibetRESUMO
OBJECTIVE: To describe opportunities and obligations for pharmacists regarding doping control in sports, and to present information and resources on drugs and dietary supplements that are popular among athletes for performance enhancement. DATA SOURCES: Sports medicine journals and articles in English obtained from Medline (1966 through June 2003) using the search terms doping in sports, drugs in sports, dietary supplements, sports, amphetamine, stimulants, ephedrine, ephedra, caffeine, anabolic steroids, human growth hormone, erythropoietin, darbepoetin, androstenedione, dehydroepiandrosterone, and creatine. Information was also obtained from sports-governing agencies, such as the National Collegiate Athletic Association and the International Olympic Committee. STUDY SELECTION: Studies and reports that were credible and scientifically sound that evaluated the ergogenic effects of drugs and dietary supplements. DATA EXTRACTION: By the author. DATA SYNTHESIS: Pharmacists can participate in doping control programs in a number of ways. Pharmacists also have an obligation when counseling, advising, and treating athletes to help them avoid banned substances. Athletes use a host of drugs for their performance-enhancing effects, many of which are banned by major sports-governing bodies. Myriad dietary supplements are marketed to athletes, claiming to have ergogenic effects. Some of these popular supplements have proven performance-enhancing effects, while others do not. Adverse effects of these drugs and dietary supplements are discussed. CONCLUSION: A variety of drugs and dietary supplements have proven performance-enhancing effects in athletes. However, many of these substances have adverse effects and are banned by various sports-governing organizations. Pharmacists can play a key role in participating in doping control programs, and can prevent athletes from inadvertently consuming a banned substance.
Assuntos
Dopagem Esportivo/ética , Dopagem Esportivo/métodos , Suplementos Nutricionais/efeitos adversos , Suplementos Nutricionais/classificação , Dopagem Esportivo/legislação & jurisprudência , Ética Farmacêutica , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/organização & administração , Papel Profissional , Automedicação/efeitos adversos , Automedicação/classificação , Estados UnidosRESUMO
Nurses and nurse midwives have historically considered patient education one of their most important responsibilities. Increasingly, however, appropriate and comprehensive patient education has become more difficult to accomplish. There are many reasons for this, including the huge influx of clients of varying cultures into virtually all health care systems across the United States, the lack of time available for patient education in tightly scheduled managed care visits, the dearth of educational materials written at appropriate readability levels and/or in languages other than English, and the lack of reimbursement for time spent on patient education. In addition, many providers might not have specific training in the provision of patient education or in the development of appropriate health educational materials for the population they serve. This article discusses these issues, suggesting also that there are ethical dilemmas inherent in the provision of some aspects of patient education.
Assuntos
Diversidade Cultural , Tocologia , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/métodos , Ética em Enfermagem , Feminino , Humanos , Gravidez , Enfermagem Transcultural/ética , Enfermagem Transcultural/métodos , Estados UnidosRESUMO
Respecting patient autonomy is a central part of the Royal College of Nursing's definition of nursing (RCN, 2003). Although autonomy is a fundamental ethical principle in health care, it stands alongside the principles of beneficence, non-maleficence and justice (Wilmot, 2003), and these principles may be interpreted differently by individuals and professional groups. In seeking to promote patient autonomy, it is therefore necessary for nurses to consider how these principles interlink, and to understand the potentially differing interpretations that they may encounter in practice. This article sets out to address these issues and suggests that facilitating patient autonomy includes engaging in debates which include uncertainties, considering the resource implications of patient autonomy and the responsibilities that patients have themselves. It also identifies that nurses who aim to promote patient autonomy and holistic decision making need to be able to facilitate discussion that may include questioning the dominant biomedical view of health. This will be problematic if nurses do not themselves feel empowered or autonomous.
Assuntos
Papel do Profissional de Enfermagem , Defesa do Paciente , Participação do Paciente , Autonomia Pessoal , Tomada de Decisões/ética , Promoção da Saúde/ética , Promoção da Saúde/métodos , Saúde Holística , Humanos , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/psicologia , Papel do Profissional de Enfermagem/psicologia , Relações Enfermeiro-Paciente/ética , Defesa do Paciente/ética , Defesa do Paciente/psicologia , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/métodos , Participação do Paciente/psicologia , Ética Baseada em Princípios , Apoio SocialRESUMO
It is argued that a doctor has a duty to provide information about reasonably available complementary and alternative medicine treatments where that information would be material to the particular patient or the hypothetical prudent patient. Given the vast array of such treatments available, doctors will want to rely on evidence-based medicine problem-solving skills to ascertain those treatments that are safe and efficacious. While the risk of litigation for failure to provide such information is probably low at this time, given the high rate of patient self-prescribing, it is necessary for a doctor to open a dialogue with a patient about complementary and alternative medicine to address safety concerns. In addition, it is important to facilitate access to the best of conventional and complementary treatments to ensure better health outcomes for the patient.
Assuntos
Terapias Complementares/legislação & jurisprudência , Medicina Baseada em Evidências , Disseminação de Informação/ética , Disseminação de Informação/legislação & jurisprudência , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Obrigações Morais , Educação de Pacientes como Assunto/ética , Educação de Pacientes como Assunto/legislação & jurisprudência , Austrália , Terapias Complementares/normas , Aconselhamento/legislação & jurisprudência , Tomada de Decisões , Humanos , Participação do Paciente , Direitos do Paciente/legislação & jurisprudência , Papel do Médico , Relações Médico-Paciente , Sociedades MédicasRESUMO
An important aspect of health professional's duty of care is to advise patients of the available options of treatment so that the patient can choose the form of treatment that suits her or his requirements. As CAM becomes more evidence-based and accepted, medical doctors need to consider the extent to which they should provide patients with information about those types of treatments. If a CAM treatment option is evidence-based, there is a strong argument that medical doctors should advise of this option for treatment to satisfy their duty. CAM practitioners should also provide details of options for treatment within their own modality but are not obliged to advise of medical options.