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
Structured water (H3O2) can be considered a fourth state of water between liquid and solid. It has the hexagonal structure of ice; however, missing a critical bond, it behaves more like a gel than a solid, but retains some of its crystalline structure.
In the past five years of my clinical practice, I have seen an astonishing upsurge in the chronic use of proton-pump inhibitor (PPI) medications for the gastrointestinal issue diagnosed by allopathic medicine as GERD. It is not uncommon to encounter patients taking these prescriptions for five-plus years.
Working with chronically ill patients entails acknowledging the reality that not all patients will survive their diagnosis. Chinese medicine and acupuncture play a crucial role in palliative and end-of-life care, addressing medication and disease side effects, alleviating pain associated with death, reducing anxiety and stress, and helping patients find peace during the dying process.
