When complementary medicine moves to hospital, ethical issues tag along
As patient demands for alternative treatments increase, so do the ethical dilemmas facing physicians. Often, there seems to be no good choice. Staff at the Vancouver Hospital recently faced the issue firsthand when the family of a Chinese man who had been severely burned in an industrial accident insisted he be given an injectable drug commonly used in China. The treatment was meant to improve his general health, but pharmacologic tests showed it could also cause neurologic damage. Although the physician in charge agreed to the treatment, he refused to administer it on the grounds that hospital rules prohibit the use of unapproved medication.
Nurses also refused after the Registered Nurses Association of British Columbia advised them against doing it. The family eventually agreed to give the injection, but because they were not properly trained the man struggled and had to be held down each time he got a needle.
Alister Browne, ethics care consultant at the Vancouver Hospital, says the real difficulty was that the patient received suboptimal care. He agrees that medical staff are obliged not to cause harm by administering treatments that have unknown benefits and could be damaging, but argues that refusing alternative care can put patients at just as much risk. "You're put in the position of somebody harming themselves," he says. "For [doctors and nurses] to watch this happen exposes them to just as much ethical and legal liability as if they had given him the drug themselves." Browne says the best solution is to do away with rules that prohibit the use of alternative medications. The change would leave patients and doctors free to make conscientious decisions about a treatment.
