In a two-part webinar on Learn ACA titled “Ethics and Evidence-based Medicine in Integrative Healthcare,” Charles Simpson, DC, DABCO discusses the intersection of ethics and evidence and explores the ethical considerations that exist in everyday healthcare practice, with an emphasis on integrative health practitioners.
“So often, continuing education programs focusing on ethics tend to look at the worst-case scenarios,” Dr. Simpson explains. “What I tried to do in the seminar was bring it back to things that, as chiropractors or as healthcare providers of any sort, we do all day every day with literally every patient that walks into the office. What are the ethical dimensions of those interactions?”
Dr. Simpson wants to help doctors understand that these ethical dimensions impact every aspect of day-to-day practice. “Once you look at what we do all day every day, with every patient, with every practitioner that we interact with, there is an undercurrent of ethics and evidence-based practice that’s going on,” he says. “We don’t necessarily back up and take a look at it from the perspective of ethics, and sometimes we don’t even think about it in terms of evidence-based medicine, but if you do that it doesn’t take long before you recognize that every time you have an interaction with a patient or another healthcare provider or anyone, ethics are operating right there, front and center.”
Dr. Simpson’s interest in the connection between ethics and evidence-based practice developed when he started a local network of integrative health professionals in Oregon, where he has practiced since his graduation from the University of Western States. When the medical community began to show more interest in managed care, Dr. Simpson and his colleagues started a network of chiropractors that soon expanded to include naturopathic medicine, massage therapy and acupuncture. He says that this was the start of his interest in an evidence-based, integrative model. The ethics emphasis came from another aspect of his career.
“The cross reference with ethics came out of my work as a medical legal consultant,” he explains. “I was kind of holding up the chiropractic end of the stick with orthopedists and neurologists and others who were in that same medical-legal arena. It was a great way for me to see where conventional medicine could benefit from the interventions of a chiropractor. Bringing that to the table in an evidence-based manner really leveled the playing field.”
In collaborating with medical professionals from other disciplines, Dr. Simpson sees firsthand the application of ethics in daily medical practice, as well as the growing appreciation for integrative health. “Often it comes down to practicing in harmony with evidence-based medicine, and those two things are operating all the time,” he says. “I think there’s real value in looking at the evidence and how it relates to ethics in the context of how integrative health meshes with the rest of medicine. Having that sense of how the evidence fits, and fits with ethics, really makes the conjunction of integrative health and conventional medicine that much easier to accomplish.”
This thread of the relationship between ethics and evidence runs through Dr. Simpson’s webinar. He discusses the principles of biomedical ethics, the application of these principles in everyday practice and more. Ultimately, he says, ethics influences day-to-day practice as well as broader perspectives in health care.
“Ethics isn’t something that sits over on the side while we’re doing the business of taking care of patients,” he says. “There are larger perspectives involved, and that’s where ethics and evidence come together — it’s really the professional obligation we all have to the larger society as a whole.”