Editor's Note: This is the conclusion of a two-article series from Dr. Pourhassani on infertility and acupuncture practice. Article #1 appeared in the November 2022 digital issue.
Before I became a fellow of the Acupuncture and TCM Board of Reproductive Medicine (ABORM), I was a member of the American Society of Reproductive Medicine (ASRM), and an integrative medicine collaborator at a large IVF center with four reproductive endocrinologists. My integrative infertility practice is mostly informed through continuing education the ASRM provides its members, and their journal: Fertility & Sterility.
Most of us (American acupuncturists) have been taught how to formulate a mission statement for our business in our master's/doctorate programs. However, we have not been advised how to formulate our ethical orientation as health care providers. (Do we need a semester of medical ethics added to our curriculum?)
Health Care Ethics
The Vermont Ethics Network defines health care ethics as follows:1
Health care ethics (aka "medical ethics" or "bioethics"), at its simplest, is a set of moral principles, beliefs and values that guide us in making choices about medical care. At the core of health care ethics is our sense of right and wrong and our beliefs about rights we possess and duties we owe others. Thinking carefully about the ethical aspects of health care decisions helps us make choices that are right, good, fair and just.
What is an acupuncturist's ethical responsibility when integrating with other medical providers? Many licensed acupuncturists in the United States have primary care privileges. Each state has its own regulations (e.g., California has educational requirements other states do not). As a primary care provider, you are not under supervision, have autonomy, and a responsibility toward the patient: to not harm and to keep them from harm.
The Ethics of Assisted Reproductive Technology
What is an acupuncturist to do when confronted with ethical questions regarding the integration of Chinese medicine with assisted reproductive technology (i.e., IVF, oocyte cryopreservation)? Most specialty boards have an ethics committee, which produces documents you can review for guidance.
If an IVF center invites an acupuncturist on a panel to promote egg freezing [oocyte cryopreservation – OC], for example, is this ethically permissible? The Ethics Committee of the ASRM has a document that may help you answer this question:2
Our ethical responsibilities in any given situation depend in part on the nature of the decision and in part on the roles we play. With more education and resources, we may be in a better position to serve the public. I highly recommend joining the American Society of Reproductive Medicine, or at least reading its Ethics Committee opinions if you are serving the infertile population, or those considering egg freezing.
Thank you for reading!
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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