3.12 Key ethical issues for CAM practitioners: competence Practitioners must have a sufficient level of competence to benefit users. The proliferation of training bodies, and the diversity of qualifications available, make it harder to know what represents an appropriate standard of pre-registration training or continuing professional development (CPD). Bringing a therapy under a single regulatory body makes it easier to set national educational standards in which diversity can be maintained, but a basic level of competence to practise is ensured. A
3.11 Key ethical issues for CAM practitioners Although CAM practitioners’ duties may vary in nature from other health professionals’ duties, the types of ethical concern remain broadly similar. The rest of this extract considers the key ethical areas underpinning standards of best practice in CAM. Although CAM practice varies dramatically in scope, all the issues listed in Author(s):
3.9 Acting ethically: tools for analysis Do the usual principles underpinning conventional health care ethics provide an adequate or acceptable framework for the discussion of ethics in the CAM relationship? Most bioethics teaching in medical schools in the UK and USA draws on the principles-based approach to considering ethical dilemmas. To recap, the four principles are: respect for autonomy the duty to benefit (beneficence) the duty not to harm (non-maleficenc
3.6 Ethical practice and accountability: the role and function of professional bodies The UK's medical profession is regulated by the General Medical Council (GMC). One of the main ways in which the GMC, and other regulatory bodies, influences its members is through its code of ethics. This sets out broad principles, rather than detailed guidance, for how practitioners should behave in specific circumstances. This is necessary because a practitioner retains individual accountability and ultimate responsibility for decisions taken during professional practice. Not all br
2.12.2 Litigation The level of litigation against CAM therapists is currently very low, particularly compared with corresponding actions being brought against doctors and other health care professionals. This, in turn, is reflected by the low annual indemnity insurance paid by most CAM practitioners. CAM therapists tend to attribute this to CAM's safety profile compared with orthodox medicine, together with CAM practitioners’ ability to forge better therapeutic relationships with users. However, other commen
2.11 The failure of CAM therapeutic relationships: complaints The issue of complaints is uncomfortable for any health practitioner. CAM practitioners may be particularly reluctant to accept that their actions may give rise to complaints. Since many therapists do not perceive their therapy to be intrinsically harmful, they are unlikely to make provision for when it goes wrong. Moreover, the comparative absence of litigation against CAM practitioners may give a false sense of security, whereby therapists do not consider themselves above the law but see th
2.10 The failure of CAM therapeutic relationships: sexual abuse and exploitation Another issue that can cause a therapeutic relationship to break down is the failure to maintain appropriate personal or professional boundaries, to the extent that it constitutes serious abuse. A broad spectrum of activities can be called abuse. The term ‘abuse’ originates from the Latin meaning ‘a departure from the purpose (use)’ (Rutter, 1990, p. 41). Given this meaning, clearly some of the boundary issues mentioned above are on the fringes of the category of abuse within CAM. Muc
2.3 Changing notions of the therapeutic relationship and responsibility The shift in practitioner-patient relationships in the last 30 years was described earlier in this book. In addition, Budd and Sharma note that in industrialised societies the nature of the majority of illnesses presented to doctors has changed from acute to chronic and, along with this, the nature of the healing relationship has also changed (1994, p. 11). For many long-term conditions, orthodox treatment can provide only short-term gains. Instead, the key issue is the management of symptoms
1.6 Models of health care delivery: the biomedical model 1.1 Introduction Since the Second World War, health has come to signify much more than an absence of physical disease for many people in western societies. Interest in health now includes concerns about food, the strength of social networks and the quality of the environment. The stresses of modern living are recognised as a serious health issue. Personal choices are positively or negatively charged, depending on whether they are ‘good for you’ or ‘bad for you’. Most newspapers and magazines publish n Acknowledgements The content acknowledged below is Proprietary (see terms and conditions). This content is made available under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence. Couse image: B References Keep on learning   There are more than 800 courses on OpenLearn for you to 2.1 The nature of the social work task Social work is a responsible and demanding job. Practitioners work in social settings characterised by enormous diversity, and they perform a range of roles, requiring different skills. Public expectations, agency requirements and resources and the needs of service users all create pressures for social workers. The public receives only a snapshot of a social worker's responsibilities and, against a background of media concentration on the sensational, the thousands of successful outcomes and 5.1.1 Linking supply and demand But apart from these relatively few enlightened examples, the efficiency with which humanity currently uses its energy sources is generally extremely low. At present, only about one-third of the energy content of the fuel the world uses emerges as 'useful' energy, at the end of the long supply chains we have established to connect our coal and uranium mines, our oil and gas wells, with our energy-related needs for warmth, light, motion, communication, etc. 5.1 Energy services Except in the form of food, no one needs or wants energy as such. That is to say, no one wants to eat coal or uranium, drink oil, breathe natural gas or be directly connected to an electricity supply. What people want is energy services – those services which energy uniquely can provide. Principally, these are: heat, for warming rooms, for washing and for processing materials; lighting, both interior and exterior; motive power, for a myriad of uses from pumping fluids to lifti 4.3.2 Wave power When winds blow over the world's oceans, they cause waves. The power in such waves, as they gradually build up over very long distances, can be very great – as anyone watching or feeling that power eventually being dissipated on a beach will know. Various technologies for harnessing the power of waves have been developed over the past few decades, of which the 'oscillating water column' (OWC) is perhaps the most widely used. In an OWC, the rise and fall of the waves inside an enclosed 4.2 Solar energy Solar energy, it should firstly be stressed, makes an enormous but largely unrecorded contribution to our energy needs. It is the sun's radiant energy, as noted in Box 2, that maintains the Earth's surface at a temperature warm enough to support human life. But despite this enormous input of energy to our civilisation, t 4.1 What are renewable energy sources? Fossil and nuclear fuels are often termed non-renewable energy sources. This is because, although the quantities in which they are available may be extremely large, they are nevertheless finite and so will in principle 'run out' at some time in the future. By contrast, hydropower and bioenergy (from biofuels grown sustainably) are two examples of renewable energy sources – that is, sources that are continuously replenished by natural processes. Renewable energy sources a 3.6 Summary This section has described how fossil fuels provide the majority of the world's energy requirements, with bioenergy, nuclear energy and hydropower also making major contributions. The other 'renewable' energy sources currently supply only a small fraction of world demand, although the contribution of these 'renewables' seems likely to grow rapidly in coming decades, as we shall see in the following section.
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