Integrating CAM within national healthcare: professionals' experiences and views of CAM integration within the NHS in the context of ethics
Abstract
Background: Decision-making in public health should be based not only on theoretical foundations and evidence for the specific approach but also on a thorough ethical consideration in the context of biomedical ethical principles. One of the areas that raise ethical discussion, is the field of complementary and alternative medicine (CAM) and the possible integration of selected CAM methods into the public system of healthcare. The high demand for CAM methods from the general public has contributed to the process of integrating selected CAM methods to some extent within the healthcare system in several countries (e.g., Switzerland, Germany, the United Kingdom, and others) as well as the fact that the World Health Organization recommends, where appropriate, in the document WHO Strategy for Traditional Medicine 2014-2023, the integration of selected CAM methods into national healthcare systems. As the United Kingdom is one of the countries that enables patients to access certain CAM approaches as a part of the National Health Service (NHS), the present study explored what ethical aspects play a role in the process of integrating a certain CAM method within healthcare. Aim of the study: This qualitative study explores professionals' experiences and views of CAM integration within the NHS in the context of ethics. The main aim is to find out in which circumstances, according to professionals based in the UK, it is ethically acceptable to integrate a particular CAM method into healthcare.
Methods: Semi-structured interviews were conducted with participants. Interviews were audio recorded, and field notes were taken. Audio recordings were transcribed verbatim. Transcripts were analysed thematically using framework methodology.
Results: A total number of 21 participants participated in the qualitative study (identified as researchers/academics, CAM practitioners, and medical doctors). The study identified a number of key topics relating to participants' views on the integration of CAM within the NHS, including the perception of CAM in the context of healthcare, safety, and regulation in healthcare and CAM, gaps in CAM research and education, or factors influencing CAM integration within the NHS.
Conclusions: The qualitative study identified key facilitators and barriers to CAM integration and the main ethical concerns in the CAM field and within healthcare in general. Further research needs to be done to explore whether the identified factors are relevant in other countries as well.