Incorporating alternative and complementary health practices into forensic medical history taking

While the prevalence of Complementary and Alternative health practices is uncertain, it is estimated that approximately one in five patients is using some form of complementary modality – whether herbs, teas,infusions, or some other traditional “folk” remedies. Whatever the true number, Complementary and Alternative medicine has become an important part of the landscape in American medicine. Whether it is traditional health practices used by patients in a culturally diverse population, or the adaptation of ancient healing arts by a traditionalist population frustrated with traditional medical care, ACM is here to stay.

Many of the substances used in folk remedies and “over the counter” cures are potent agents, and some are patently toxic. Persons using these unregulated “cures” often mix them with traditional medicines. Alone or in combination, there are often adverse effects.

The typical medical history taken by a primary care physician or an emergency responder is not designed to detect these sorts of substances. The typical occupational health physician or forensic medical-legal examiner does not elicit information about these practices. And in a typical legal setting, alternative medicines and folk practices is virtually unknown.

This presentation draws on real life experiences to demonstrate the ways in which medical histories and forensic examination techniques can be refined and restructured to explore non-traditional health practices and help to better understand the patient's signs and symptoms, and their causes.