Our Code of Ethics
First do no harm (primum non nocere).
This Hippocratic oath is the most honored text every student of medicine is aware of (ref. 1). This oath was originally intended to protect human health. As careful study of the history of medicine reveals, some “cures” used to treat disease were often worse than the disease itself. As recently as 100 years ago, for example, arsenic, mercury and opium were used medicinally (ref. 2). Physicians still grapple with side effects of prescription drugs and excessive medicalization of our lives (ref. 3). Regardless of increased use of synthetic drugs, the state of our health in the U.S. is rapidly declining. The incidence of diabetes type 2, in example, has doubled over the last ten years. Now we have to deal with the ill health of our polluted planet, with chemicals and prescription drugs decimating birds in Pakistan, Nepal and India (ref. 4), and polluting our drinking water (ref. 5).
There is mounting body of evidence that the Hippocratic oath of doing no harm is becoming a norm in mainstream medicine and industry in general worldwide. Numerous medical organizations and universities address and explain the true etiology (causes) of “modern world” “diseases.” Recently, the entire country of Japan implemented the program of nutritional interventions and exercise and applied it to its entire population as a safe and cost-effective solution designed to prevent epidemic of obesity and its complications. A new model of industry emerges in the U.S. and worldwide that promotes environmental stewardship and avoids use of chemicals that are harmful or outright deadly to our health, and the health of our rivers and oceans (ref. 6, 7). Many towns, like Portland, Oregon, have witnessed a boom in organic farming and a culture of wellness. It is now an unstoppable movement. Many countries embrace the Precautionary Principle and require testing of all substances that may affect our health or environment.
Prioritize prevention and do no harm (primum praevenire et non nocere).
The original Hippocratic oath needs to be fully respected. However, in order to meet the heightened expectations of modern medicine and contemporary Homo sapiens, it has to be further enhanced to encourage truly preventive care.Primum praevenire et non nocere is our standard of ethics. I hope this expanded oath will become the ultimate standard of medical care worldwide.
Honor the healing power of nature (vis medicatrix naturae).
This ancient advice is even more valid in our times, where we are so often stressed-out and deprived of beneficial daylight, fresh air, opportunities to exercise, sufficient vacation time, and high-nutrient-content foods. ”Spontaneous healing is not a miracle but a fact of biology—the result of the natural healing system that each one of us is born with.”—is the elegant statement from Dr. Andrew Weil’s book that everyone should read—Spontaneous Healing (ref. 8).
Respect the patient’s right to know of the best and the safest treatment or cure options, of the interventions that will improve the quality of their lives, lead to improvement of the state of health, or the resolution of the disease state.
Some of the best and the safest treatments may also be least expensive and at times, when the treatment involves dietary modifications, self-administered physical therapy or an exercise program, totally free. Some of the best treatments may not be available in every state. The AMA’s medical ethics code states that physicians “have an ethical obligation to assure the disclosure of medically appropriate treatments alternatives, regardless of cost.” It is the obligation of the physician to have honest conversations with the patients and to inform patients of effective and available services, regardless of insurance coverage.
Include and involve patients in the decision-making process.
Making the major treatment decision without educating and involving individual patient is highly unethical.
All patients must have unrestricted access to consultants for second or third opinions, as well as being encouraged to become active participants in their care.
In my opinion, the best patient is the well-informed patient. As the knowledge base and experience of individual physicians differ, patients should be allowed unrestricted access to a physician of their choice.
It is improper and unethical to treat well documented nutrient deficiency-related conditions with synthetic drugs.
Classic examples: 1) Post-surgical wound dehiscence (separation, bursting open) that is caused by severe deficiency of vitamin C, must be treated by correction of dangerously low levels of vitamin C. It is a well-known and obvious fact that severe deficiency of vitamin C, also known as scurvy, leads to inability of surgical wounds to heal and to disintegration of blood vessel walls. 2) Severe deficiency of vitamin B12 that is sustained over prolonged time leads to severe depression, brain atrophy (shrinking, wasting away of the brain) and dementia. The prudent action is to test all patients who suffer from depression and dementias for vitamin B12 deficiency and deficiency of some other critical nutrients that may lead to neurological and psychiatric problems. Numerous other medical and neurological conditions are direct results of moderate or severe, and at times even mild deficiency of one (or more) of over 40 critical vitamins, minerals and nutrients.
When the safer and more powerful natural remedy is available, this is what should be used.
The issue of ethics must also apply to choice of medications. Medical ethics require physicians to inform patients of the availability of the safest, most effective medical treatments. This must include information about the availability of state-of-the-art botanical medicines and other natural remedies. The issue or claim that botanical products are not tested and are of questionable quality and purity must be immediately ridiculed and rejected, as the highest-quality, pure, standardized, hypoallergenic botanical products are already widely and readily available. Those highest-quality products are manufactured in state-of-the-art facilities, with each batch of a finished product being tested and certified as to the potency and purity of every ingredient—by FDA-certified independent laboratories. Now available, those quality products exceed the stringent standards of the United States Pharmacopoeia (USP), as well as other (proposed by the FDA) Good Manufacturing Practices guidelines, and this is the quality of products I recommend. It is unethical to misinform, to withhold information about inexpensive, safe, natural treatment options only because they are “natural,” when their effectiveness is scientifically proven, widely accepted and treatments have been used successfully worldwide.
It is imprudent to preferentially use synthetic medicinal products when safer, environmentally friendly, and extremely effective and less expensive natural products are readily available and easy to produce.
It is good to know that the art and science of growing high-quality botanical products and manufacturing of natural remedies has been perfected, thus assuring a steady supply of premium quality natural supplements and treatments. It is also good to know that botanical medicines, being based on naturally grown or carefully cultivated plants, or actually being the parts of such plants, have low or no adverse environmental impact on our soil and water or on other plants—unless someone wanders into the poorly charted territory of genetically engineered foods and plants. In this instance, reckless and unethical activity may bring on biological disasters of contamination by cross-pollination of native and valuable agricultural crops, or by other mechanisms not yet known to us (ref. 9).
It is unethical to endorse, encourage, or promote unhealthy behavior just because the medication, be it synthetic or botanical, to treat a particular condition is available, in order to enhance that medication’s sales.
The salesman’s “practice” of medicine with ads that often contain subtle suggestions that it is fine to continue unhealthy behavior, as long as ill person buys the drug or supplement to palliate the symptoms, is highly unethical and should be condemned. The proper strategy is to involve a practicing physician who will advise on measures that prevent or relieve a condition by advising prudent dietary means and the safest, most appropriate treatment.
It is unethical to promote a product as working like a “magic bullet.”
Even when the product is beneficial or effective, it is well known that it takes a combination of healthy lifestyle, proper nutrition, physical activity and correction of any nutrient deficiencies to ensure the best possible state of wellness. The idea that the individual may continue with an unhealthy diet or behavior—and continue taking a particular prescription drug, vitamin or any other natural product—should be viewed as highly unethical.
It is well known that the best result, such as virtually eliminating the need for neck artery surgery or heart coronary artery bypass surgery are accomplished only with an integrative medical approach, by combining the healing power of all beneficial activities and the safest, most effective treatments. The same applies to other chronic conditions, such as arthritis, where the complete elimination of inflammation is accomplished only with an integrative approach.
Another group of conditions that may be prevented or corrected by use of an integrative medical approach includes depression, anxiety, chronic agitation, lack of self-control, vitamin B12 deficiency-related-dementias that include Alzheimer’s, sodium-deficiency-related confusion and severe magnesium-deficiency related psychosis. Those conditions require the removal of toxic or offending dietary factors, as well as correction of nutrient or vitamin deficiencies, and such an approach leads frequently to prompt and complete recovery, improvement or at least to stabilization of the condition. To treat any of those conditions without prior metabolic evaluation, without attempting to identify a particular condition’s cause—is wrong, and highly unethical.
Public advocacy that advances better health, when done in an impartial way, is the highest virtue of a citizen.
Public advocacy that shows the way to better health, cleaner drinking water and more nutritious foods, as well as protecting the environmental health and promoting planet-friendly enterprise, should be respected and rewarded with the Medal of Honor. The promoters of toxic, contaminating or polluting products should be discredited as their activities are against the long-term national and human interest.
1. Hippocrates (460-377 B.C.) is considered the founder of modern medicine. Hippocrates is best known for Hippocratic Oath recited by medical school graduates.
2. Arsenous acid (U.S.P.) was used internally to treat malarial fever, skin diseases, chorea, neuralgia, gastralgia (stomach aches), uterine disorders, diabetes, and bronchitis. No longer used for obvious resons. Some other used then, and now considered toxic or otherwise dangerius: ammonium arsenate, mercury cyanide (to gargle), mercury tannate, mercury sulphate (to induce vomiting), mercury for skin problems, opium, potassium arsenite, Source of this information: facsimile of the first, 1899 edition of The Merck Manual, titled Merck’s 1899 Manual that was reprinted in 1999. Copy of this historic textbook “illustrates the enormous advances in medical knowledge and practice that have taken place over the past 100 years.” I agree. Regardless, we still have some work to do, as our American population is overweight and diabetes and heart disease is rampart, and currently used prescription drugs cause heavy contamination of rivers and oceans. As 100 years ago, too many of currently used prescription medications and many “over-the-counter” products are still toxic—have serious side effects—to us and our environment, as reported by government organizations and scientists examining waters of eastern states (Juliet Eilperin Pharmaceuticals in Waterways Raise Concern— Effect on Wildlife, Humans Questioned Washington Post, June 23, 2005).
3. Synthetic and mare-sourced prescription estrogen drugs were promoted for years as almost cure-all. Now, thanks to U.S. government sponsored studies, we now better. Although estrogens are beneficial to selected patients, these products are associated with increased incidence of strokes, blood clots, heart attacks, dementias, urine incontinence, uterine and breast cancers, and more (Heart and Estrogen/Progestin Replacement Study (HERS). JAMA. 280(7):605-613, 1998.). Fortunately, there are safe and effective dietary approaches that give women needed comfort. Further, recent decrease in use of synthetic estrogens resulted in a significant decrease of incidence of breast cancers.
4. Susan McGrath. The Vanishing—Little noticed by the outside world, perhaps the most dramatic decline of a wild animal in history has been taking place in India and Pakistan. Large Vultures, vitally necessary and once numbering in the tens of millions, now face extinction. But why? Smithsonian (February 2007).
5. Juliet Eilperin. Pharmaceuticals in Waterways Raise Concern— Effect on Wildlife, Humans Questioned. (Article, Washington Post, June 23, 2005, Page A03)
6. Peterson R. Cause for Great Lake trout reproduction failure, Sea Grant University of Michigan. February 13, 1997.
7. Steroids were found in 89 percent of streams, followed by nonprescription drugs (81%), insect repellents (74%), detergent metabolites (69%), disinfectants (66%), plasticizers (64%), fire retardants (60%), antibiotics (48%), insecticides (45%), PAHs (44%), hormones (37%, other prescription drugs (32%), antioxidants (29%), Fragrances (27%) and solvents (24%). (Juliet Eilperin: Pharmaceuticals in Waterways Raise Concern— Effect on Wildlife, Humans Questioned an article published in June 23, 2005 issue of Washington Post.)
8. Andrew Weil, M.D. Spontaneous Healing. Ballantine Books, New York, NY:1995.
9. Example of safe products that is versatile and so important that there is no normal life without it magnesium. Other examples: silymarin that regenerates and protects liver, 3-A CalciumÒ—the enhanced calcium product that is free of heavy metals and reverses osteoporosis, and C-12 Peptide that was mentioned in so many medical journals, both so safe, that are available without prescription.