Medical Ethics

Herbal Medicine: Another Medical Ethical Battlefield?

By April 25, 2014 No Comments

Up until very recently, herbal medicine was considered pretty much a pariah as a topic of conversation in polite medical circles. After all, why talk to a patient of an inexpensive 2,000 year-old Chinese herbal remedy for arthritis, when the drug rep for an arthritis pill manufacturer just slipped you four tickets to the Chinese Medicineplayoffs? However, a quiet revolution may be taking place that may become an ethical battlefield pitting ancient wisdom against modern Big Pharma.

Parsing my words

Generally speaking, I have been critical of the outrageous prices Americans must pay for the pharmaceuticals prescribed to them as opposed to the prices a patient in Canada must pay for the identical pill, ointment, solution – whatever. The pharmaceutical companies, FDA and a host of other players try to give us explanations and those explanations always fall short. However, I am not as critical of physicians and researchers who develop the pharmaceuticals. I believe they try to do their best. I do not believe they keep deep, dark breakthrough secrets for their own private use, and give us the “fake treatments.”

However, there is a lingering doubt I have often nurtured in my thoughts. Let’s say there is an ancient Chinese herb that has traditionally shown itself effective and safe in use for arthritis. And, I might add, cheap. Then let us take a pharmaceutical that claims it to be effective, maybe not quite as safe and moderately expensive. Why don’t our physicians consider prescribing the herbal remedy?

It is a question now being asked even in serious medical circles.

On April 23, 2014, The Wall Street Journal published an online article entitled: “Top hospital opens up to Chinese herbs as medicines.”

The prestigious Cleveland Clinic is plunging into the middle of an ethical minefield. According to the article: “The Cleveland Clinic, one of the country’s top hospitals, is a surprising venue for the dispensing of herbs, a practice that is well established in China and other Eastern countries but has yet to make inroads in the U.S. because of a lack of evidence proving their effectiveness… Patients must be referred by a doctor and will be monitored to ensure that there are no drug-herbal interactions or other complications.”

Interesting stuff

I understand caution – and I applaud the Cleveland Clinic for its monitoring patients on these herbal medicines, but the clinic raises many interesting issues.

Even if proven to be half as effective as an expensive pharmaceutical, is it not the herbal medicine still worth trying? I might add another ethical wrinkle at this point and ask that if a pharmaceutical (though somewhat more effective) has many side-effects, is that not reason enough to start with the herbal remedy? Oh yes, let us not forget the topic of cost. Right now, America is in the midst of a huge healthcare debate. It is no secret that many Americans (and I know some) who are walking about with no healthcare coverage at all. If one of these fine folks can potentially get relief from an herbal remedy at a fraction of the cost of a pharmaceutical, why shouldn’t this patient receive the cheaper treatment?

In addition, I am sure that many of us have known people who have also suffered severe drug reactions to pharmaceuticals because they were not monitored closely enough. It is somewhat disingenuous to apply tighter scrutiny to herbs as opposed to other treatments.

Obvious points

In the article, Melissa Young, an integrative medicine physician at Cleveland Clinic was quoted as saying:

“Western medicine does acute care phenomenally.… But we’re still struggling a bit with our chronic-care patients and this (herbal remedies) fills in that gap and can be used concurrently.”

Dr. Young is absolutely correct. Western medicine does many things phenomenally well. There can be no argument. There are many diseases that have had magnificent cure rates thanks to Western medicine. But there are other diseases that have also responded well to herbal treatments.

To me, the wisest course is to do what is right for the patient by taking the best of everything. It sounds a simple enough solution, however I see major ethical battles looming over such decisions.

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