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To the Editor: While we concur with Dr Miller and colleagues¹ that the evidence for making practice and public health decisions in CAM should come from large, double-blind, randomized controlled trials (RCTs), we believe there are 2 key ethical issues in CAM research that the authors should have addressed. First, who determines the "social value" of CAM research? Second, use of the terms "placebo" and "non-specific" ignores the complexity of clinical responses found when delivering therapies in a rich and meaningful context.

The widespread use of CAM is a public health issue. Consequently, the public should have a role in determining its research focus and priorities. The ethical need for a systematic process to obtain input and priorities by the public and CAM practitioners has been extensively discussed elsewhere.^2-4 These discussions call for an expanded vision of research quality that answer questions beyond those of "efficacy." In other words, CAM . . . [Full Text of this Article]

Wayne B. Jonas, MD
wjonas@siib.org

Christine Goertz, DC, PhD; John Ives, PhD
Samueli Institute
Alexandria, Virginia

Ronald A. Chez, MD
Samueli Institute
Corona del Mar, Calif

Harald Walach, PhD
Samueli Institute
Freiburg, Germany