Shared decision making in complementary and alternative medicine therapies.

OBJECTIVE

This paper provides a structured approach for pediatricians responding to requests from patients and their families about the complementary medicine treatment options.

METHODS

Using a case-based narrative review approach, the authors outline practical strategies for addressing conflict, uncertainty, and challenges in explaining alternative health paradigms in routine pediatric care. Reflections are drawn from the clinical experience of the authors, the literature, and recent high-profile cases in the United States.

RESULTS

The discussion of common case-based scenarios illustrates a general guide for approaching conversations about complementary medicine in the care of the pediatric patient that is responsive to evidence and informed by patient and family values.

CONCLUSIONS

The principles of shared decision making can guide constructive conversations in this area in an effort to facilitate improved satisfaction for patient, family, and provider.

PRACTICE IMPLICATIONS

Discussions of complementary and alternative medicine in pediatrics pose a specific challenge with regard to patient and/or family preferences and the duty of the provider to advocate for the safety of the child. The proposed structured approach is useful in navigating these important conversations.