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National Policy on CAM: The White House Commission Report

Published online by Cambridge University Press:  01 January 2021

Kathleen M. Boozang
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Extract

In March 2000, President William Clinton signed Executive Order 13,147, establishing the White House Commission on Complementary and Alternative Medicine, to develop public policy proposals geared toward maximizing “the benefits to Americans of complementary and alternative medicine.” Disconcertingly, the Commission's charge presumed the safety and efficacy of complementary and alternative medicine (CAM). In so doing, it placed the proverbial cart before the horse by setting the Commission on a mission to “address education and training of health care practitioners in CAM; [coordinate] research to increase knowledge about CAM products; [provide] reliable and useful information on CAM to health care professions, and [provide] guidance on the appropriate access to and delivery of CAM.”

The Commission's final report (“Commission Report”), issued in March 2002, similarly skirts the fundamental question of whether evidence exists that CAM interventions are safe or offer sufficient benefit to justify their proliferation.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 31 , Issue 2 , Summer 2003 , pp. 251 - 261
Copyright
Copyright © American Society of Law, Medicine and Ethics 2003

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References

Exec. Order No. 13, 147, 65 Fed. Reg. 13, 233 (March 7, 2000).Google Scholar
White House Commission on Complementary and Alternative Medicine, Final Report (2002): At 1, available at <http://govinfo.library.unt.edu/whccamp/pdfs/fr2002_document.pdf>..>Google Scholar
Eisenberg, D.M. et al., “Trends in Alternative Medicine Use in the United States, 1990–97,” JAMA, 280 (1998): 1569–75.CrossRefGoogle Scholar
Thanks to a peer reviewer for suggesting this point.Google Scholar
See generally Boozang, K.M., “Is the Alternative Medicine?: Managed Care Apparently Thinks So,” Connecticut Law Review, 32, no. 2 (2000): 567–613, at 580–86 and accompanying notes.Google Scholar
Letter from Stephen Graft, White House Commission Executive Director, to KM. Boozang (January 31, 2003) (on file with author).Google Scholar
White House Commission on Complementary and Alternative Medicine, supra note 2, at xviii.Google Scholar
Hufford, D.J., “CAM and Cultural Diversity: Ethics and Epistemology Converge,” in Callahan, D., ed., The Role of Complementary & Alternative Medicine: Accommodating Pluralism (Washington, D.C.: Georgetown University Press, 2002): 15–35.Google Scholar
Representative Dan Burton, as chair of the House Government Reform Committee, established an oversight inquiry regarding the role of CAM in the U.S. health care system.Google Scholar
See, e.g., Patient Access to Acupuncture Services Act of 1998, S. 2340, 105th Cong. (1998) (to provide acupuncture coverage under Medicare and the Federal Employees Health Benefits Program).Google Scholar
See, e.g., FDA Patient Rights Act, H.R. 3677, 106th Cong. (2000); Access to Medical Treatment Act, H.R. 2635, 106th Cong. (1999).Google Scholar
See generally Reynolds, T., “White House Report on Alternative Medicine Draws Criticism,” Journal of the National Cancer Institute, 94 (2002): 646–48.CrossRefGoogle Scholar
White House Commission on Complementary and Alternative Medicine, supra note 2, at 33.Google Scholar
Id. at 136.Google Scholar
Id. at 6.Google Scholar
Id. at 33.Google Scholar
Id. at 22.Google Scholar
Id. at 88.Google Scholar
Id. at 100.Google Scholar
See Boozang, , supra note 5.Google Scholar
White House Commission on Complementary and Alternative Medicine, supra note 2, at 109.Google Scholar
Id. at 127.Google Scholar
Id. at 226–33 (Appendix G: Letter from Commissioners Joseph Fins, M.D., and Tieraona Low Dog, M.D.), available at <http://www.whccamp.hhs.gov/sfc.html>..>Google Scholar
Id. at 227.Google Scholar
Id.Google Scholar
S. Rep. No. 107–222, at 6 (2002).Google Scholar
S. Rep. No. 107–216, at 69 (2002).Google Scholar
S. Rep. No. 107–213, at 226 (2002). The Department of Defense was previously mandated by Congress to conduct two CAM demonstration projects: The Chiropractic Health Care Demonstration Program and the Ornish Lifestyle Modification Program. H.R. Rep. No. 106–1053 (2001).Google Scholar
H.R. Rep. No. 107–229 (2002).CrossRefGoogle Scholar
Holcombe, R.G., “Eliminating Scope of Practice and Licensing Laws to Improve Health Care,” Journal of Law, Medicine & Ethics, 31, no. 2 (2003): 236–46.Google Scholar
Ginzberg, E. and Dutka, A.B., The Financing of Biomedical Research (Baltimore: Johns Hopkins University Press, 1989): At 19.Google Scholar
See Celebrities Ask for More Diabetes Research Funds, CNN.com/HEALTH, at <http://www.cnn.com/2001/HEALTH/conditions/06/26/diabetes.hearing/> (posted June 28, 2001) (Astronaut James Lovell, Kevin Kline, and Mary Tyler Moore testified before Congress for increased funding for diabetes research); Cho, A., Healing Power of Fame, abcNEWS.com, at <http://abcnews.go.com/sections/entertainment/DailyNews/celebrities_research021130.html> (posted November 30, 2002) (Christopher Reeve has several times testified before Congress about finding a cure for paralysis; Michael J. Fox and Muhammad Ali have testified before a Senate committee to increase funding for Parkinson's disease; Julia Roberts has testified before Congress to increase funding for Rett syndrome).+(posted+June+28,+2001)+(Astronaut+James+Lovell,+Kevin+Kline,+and+Mary+Tyler+Moore+testified+before+Congress+for+increased+funding+for+diabetes+research);+Cho,+A.,+Healing+Power+of+Fame,+abcNEWS.com,+at++(posted+November+30,+2002)+(Christopher+Reeve+has+several+times+testified+before+Congress+about+finding+a+cure+for+paralysis;+Michael+J.+Fox+and+Muhammad+Ali+have+testified+before+a+Senate+committee+to+increase+funding+for+Parkinson's+disease;+Julia+Roberts+has+testified+before+Congress+to+increase+funding+for+Rett+syndrome).>Google Scholar
Dresser, R., When Science Offers Salvation: Patient Advocacy and Research Ethics (London: Oxford University Press, 2001): At 24.Google Scholar
Schneiderman, L.J., “The (Alternative) Medicalization of Life,” Journal of Law, Medicine & Ethics, 31, no. 2 (2003): 191–97.CrossRefGoogle Scholar
Ayurvedic medicine is an ancient system of health based on a balance of mind, emotion, spirit, and body using both preventative and corrective treatments. Vasant Lad, D., “Ayurvedic Medicine,” in Jonas, W.B. and Levin, J.S., eds., Essentials of Complementary and Alternative Medicine (Philadelphia: Lippincott, Williams & Willems, 1999): At 576–77.Google Scholar
Homeopathy is a healing method based on the law of similars that uses diluted medicines to trigger the body's natural healing processes. Chapman, E. H., “Homoeopathy,” in Jonas, W.B. and Levin, J.S., eds., Essentials of Complementary and Alternative Medicine (Philadelphia: Lippincott, Williams & Wilkins, 1999): At 580.Google Scholar
Naturopathy is a philosophy and lifestyle that emphasizes the body's natural and self-healing abilities and uses natural foods and medicines to support those abilities. Murr, M.T. and Pizzorno, J.E., “Naturopathic Medicine,” in Jonas, W.B. and Levin, J.S., eds., Essentials of Complementary and Alternative Medicine (Philadelphia: Lippincott, Williams & Wilkins, 1999): At 581.Google Scholar
Traditional Chinese medicine is a system of medicine that views the balance among bodily functions and the balance between the body and nature as the source of health, and imbalances as the source of disease. Lao, L., “Traditional Chinese Medicine,” in Jonas, W.B. and Levin, J.S., eds., Essentials of Complementary and Alternative Medicine (Philadelphia: Lippincott, Williams & Wilkins, 1999): At 584.Google Scholar
Biomedicine comprises the school of medical thought dominant in Western cultures. It is also referred to as conventional or allopathic medicine.Google Scholar
Milton, D. and Benjamin, S., Complementary & Alternative Therapies (Chicago: American Hospital Publishing, 1999).Google Scholar
Barrett, S., “‘Alternative’ Medicine: More Hype than Hope,” in Humber, J. and Almeder, R., eds., Alternative Medicine and Ethics (New York: Humana Press, 1998): 1–42, at 21.Google Scholar
Id.Google Scholar
See generally Lacey, H., Is Science Value Free?: Values and Scientific Understanding (London: Routledge, 1999): At 10.Google Scholar
Id. at 14.Google Scholar
Hufford, , supra note 8, at 17.Google Scholar
See generally Lacey, supra note 43, at 102.Google Scholar
See Cal. Bus. & Prof. § 2053.5 (2003); Minn. Stat. § 146A.01 (2003); Fla. Stat. Ann. § 456.41 (2003); An Act to Amend the Education Law, in Relation to Granting Freedom of Access to Alternative Health Care, 2003–2004 N.Y. Reg. Session 6973 (March 17, 2003).Google Scholar
See, e.g., Eisenberg, D.M. et al., “Unconventional Medicine in the United States — Prevalence, Costs, and Patterns of Use,” N. Engl. J. Med., 328 (1993): 246–52; van den Hoogen, H.M. et al., “On the Accuracy of History, Physical Examination, and Erythrocyte Sedimentation Rate in Diagnosing Low Back Pain in General Practice: A Criteria-Based Review of the Literature,” Spine 20 (1995): 318–27.CrossRefGoogle Scholar
National Institutes of Health, Setting Research Priorities at the National Institutes of Health, No. 97–4265 (1997): At 4, available at <http://www.nih.gov/about/researchpriorities.htm>..>Google Scholar
See generally Shrader-Frechette, K.S., Science Policy, Ethics, and Economic Methodology (Boston: D. Reidel Publishing Co., 1985): At 32–33.Google Scholar
National Institutes of Health, supra note 49.Google Scholar
Id.Google Scholar
On October 21, 2002, NIH announced that the Institute of Medicine would conduct a 2-year $1 million study to analyze existing data on CAM to address the methodological difficulties in evaluating CAM therapies; regulation of the CAM profession in the United States; coverage of CAM by insurers or third-party payers; and licensing and certification of CAM practitioners. See NIH Announces Institute of Medicine Study of Complementary and Alternative Medicine, press release (October 21, 2002), at <http://www.nih.gov/news/pr/oct2002/nccam-21.htm>..>Google Scholar
Dresser, , supra note 33, at 29.Google Scholar
See generally Freedman, B., “Equipoise and the Ethics of Clinical Research,” N. Engl. J. Med., 317 (1987): 141–45.CrossRefGoogle Scholar
Pildes, R.H. and Sunstein, C.R., “Reinventing the Regulatory State,” University of Chicago Law Review, 1 (1995): 1–129.CrossRefGoogle Scholar
Shackley, P. and Donaldson, C., “Should We Use Willingness to Pay to Elicit Community Preferences for Health Care? New Evidence from Using a ‘Marginal’ Approach,” Journal of Health Economics, 21 (2002): 971–91.CrossRefGoogle Scholar
This argument was advanced by participants at the September 2002 Pitts Memorial Lectureship at the Medical University of South Carolina.Google Scholar
Pildes, and Sunstein, , supra note 56.Google Scholar
See generally Shrader-Frechette, supra note 50, at 42.Google Scholar
Gross, C.P., Anderson, G.F. and Power, N.R., “The Relation Between Funding by the National Institutes of Health and the Burden of Disease,” N. Engl. J. Med., 340 (1999): 1881–87.CrossRefGoogle Scholar
Pildes, and Sunstein, , supra note 56.Google Scholar
Dresser, R., “Public Advocacy and Allocation of Federal Funds for Biomedical Research,” Milbank Quarterly, 77 (1999): 257–74.CrossRefGoogle Scholar
Dresser, , supra note 33.Google Scholar
National Institutes of Health, supra note 49, at 11.Google Scholar