Ethical Considerations in Integrative Medicine

Abstract

Integrative medicine occupies a specific ethical territory that conventional biomedical ethics does not fully map onto. Traditional medicine systems, Ayurveda included, carry ethical commitments that developed alongside classical medical practice and do not always align cleanly with modern biomedical ethical frameworks. At the same time, modern biomedical ethics has well-developed answers to problems that traditional-medicine practice does not always frame the same way. We consolidated 64 peer-reviewed studies and position papers published between 2014 and 2024 examining ethical dimensions of integrative-medicine practice. Studies were grouped into five frames: E1 (informed consent and disclosure), E2 (equity and access), E3 (knowledge rights and cultural appropriation), E4 (evidence-based practice tensions with traditional lineage), and E5 (practitioner scope-of-practice and patient safety). Each frame was scored on the Integrative Medicine Ethics Index (IMEI), a weighted composite across patient autonomy, justice and equity, non-maleficence, knowledge rights, and accountability. Informed consent and disclosure (E1) and practitioner scope-of-practice (E5) scored highest at IMEI 0.818 and 0.794. Our reading is that integrative-medicine ethics has developed a working framework across most dimensions, but that knowledge-rights questions - particularly around biopiracy and traditional-knowledge commodification - remain ethically unresolved and deserve continued attention.