Ethical and legal issues at the interface of complementary and conventional medicine

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In reply: We agree with Kotsirilos and Hassed that there are many examples of successful integration of “proven” CAM into conventional medical practice. Our question, however, is whether it is possible to integrate CAM where its theoretical maxims and practices are incommensurate with allopathic medicine (eg, homoeopathy) and whether “integrative medicine” will ulti-mately fragment and diminish CAM, further isolate “non-evidence-based” CAM practi-tioners and make less visible those views of health and disease that are not consistent with modern medicine.1

Correspondence:

1. Faass N. Integrating complementary medicine into health systems. Gaithersburg: Aspen Publications, 2001.
2. Balon J, Aker PD, Crowther ER, et al. A comparison of active and simulated chiropractic manipulation as adjunctive treatment for childhood asthma. N Engl J Med 1998; 339: 1013-1020.
3. Cordeiro N, Oniyangi O. Phytomedicines (medicines derived from plants) for sickle cell disease. Cochrane Database Systematic Rev 2004; 3: CD004448.
4. Jepson RG, Milhaljevic L, Craig J. Cranberries for preventing urinary tract infections. Cochrane Database Systematic Rev 2004; 1: CD001321.
5. Pittler MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Systematic Rev 2004; 2: CD003230.
6. Izzo AA, Ernst E. Interactions between herbal medicines and prescribed drugs. A systematic review. Drugs 2002; 61: 2163-2175.

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