[Duties of the Physician in Relation to the Use of Alternative and Complementary Medicines by Their Patients].

Abstract

In the prevailing medical pluralism of contemporary society, alternative and complementary medicine occupy a relevant place, comprising a heterogeneous group of practices with different values depending on tradition and social acceptance. Their scarce regulation and growing use, facilitated by promotion through social networks and distrust of the dominant biomedical model, have generated interest among medical organizations and health authorities in their use and consequences. Appreciations vary from outright rejection to interest in its adoption by public health systems as part of their services. Its growing use, however, contrasts with an incipient development of the scientific evidence supporting its use and, consequently, a scarce representation of its curricular teaching in our medical schools. The use of CAM by patients cannot be ignored in the therapeutic encounter. Physicians must be prepared to discuss their possible benefits and risks with their patients and to make recommendations in accordance with the principles of medical professionalism: the good of the patient must take precedence over other interests, taking into account the scarce scientific evidence of their efficacy and safety, the imperfect regulation to which they are subject and the lack of pharmacovigilance on their effects. The patient's autonomy over his or her health care, considerations regarding the use of scarce health care resources, and the due compassion and empathy owed to the patient as a suffering being cannot be ignored.