Ethical obligations in mind/body research and practice: Compelled by, and sustaining a patient-centered focus of care

Advances made by twentieth century medicine have positively impacted the public health by reducing mortality, but have also led to an increased morbidity of chronic diseases and longitudinal illness. Such illness is often refractory to the curative medical model, but is frequently responsive to more healing approaches, including those that fall within the rubric of mind-body medicine. Recently many of these approaches (e.g.- placebo responses, meditation, yoga, etc.) have been viewed with appreciation by the research and clinical communities, and this has evoked considerable public interest in, and use of such techniques. Compelling questions persist regarding the outcomes, mechanisms, applications and limitations of these approaches and effects, reinforcing the need for research that is compelled by clinical questions, methodologically rigorous, yet responsive to the special demands of addressing the underlying “hard question(s)” of conscious processes. Thus, we maintain that research in this field must be advanced to meet the ethical obligations of medicine to effectively serve the public health. Information is required that empowers clinicians to execute stewardship of knowledge and sustain the fiduciary medical relationship. Evidence-based research is critical to determine specific viability, and uses of particular mind-body approaches within a more integrative model of clinical care. We argue that research findings expand the capacity for beneficence and insure that the core philosophical tenets of medicine be fulfilled. We propose that these ethical obligations increase epistemic capital, furthering the cooperation between the basic sciences and clinical practice, and advance consilience between biomedicine and the humanities.