1. A social commitment to public welfare. In terms of medical therapies, a commitment to public welfare is the obligation to generate and provide to health care practitioners, policy makers, and the public access to the best information available on the efficacy of CAM therapies. This is a duty of beneficence (Beauchamp and Childress, 1994; Churchill, 1995).

2. A commitment to protect patients and the public generally from hazardous medical practices and to inform practitioners, policy makers, and the public of select therapeutic modalities that are potentially injurious or deleterious to health. This commitment is closely related to the first one and is often expressed in the bioethics literature as a duty of nonmaleficence, and by physicians as primum non nocere—first, do no harm, which comprises the Hippocratic Oath from the sixth century B.C.E. (Beauchamp and Childress, 1994). As will be discussed in this chapter, nonmaleficence in approaching CAM therapies by individual practitioners includes respecting divergent cultural beliefs; creating an emotionally safe environment for the discussion of CAM; and appreciating how CAM may fit into a patient’s larger social, familial, or spiritual life (Adams et al., 2002; Cohen, 2003). Nonmaleficence in policy decisions includes such things as devising appropriate research strategies and labeling and advertising policies that protect the public.

3. A respect for patient autonomy (or in social terms, a commitment to consumer choice in health care). Autonomy expresses the interest in allowing and actively enabling individuals to make knowing and voluntary choices in health care, in accord with their own values. Such choices cannot be made without the provision of information regarding benefits and risks that are implied in the first two commitments, so in this way respect for the autonomy of patients (and choice for consumers) is possible only when individuals and social agencies exercise beneficence and nonmaleficence when they are in the position to do so (Beauchamp and Childress, 1994).

4. Recognition of medical pluralism (Callahan, 2002; Kaptchuk and Eisenberg, 2001). Serious consideration of the safety, efficacy, and potential integration of CAM therapies into conventional medicine means acknowledgement of multiple valid modes of healing and a pluralistic foundation for health care. Many CAM practices (such as chiropractic, acupuncture, naturopathy, and homeopathy) are rooted, at least in part, in forms of evidence and logic other than those used in biomedical sciences, often with long traditions and theoretical systems of interpretation divergent from those used in biomedicine. Investigation of CAM practices entails a moral commitment of openness to diverse interpretations of health and healing, a commitment to finding innovative ways of obtaining evidence, and an expansion of the knowledge base relevant and appropriate to medical practice. This commitment to openness also includes reconsideration of