{"id":4760,"date":"2026-03-11T06:39:27","date_gmt":"2026-03-11T05:39:27","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4760"},"modified":"2026-03-11T06:39:27","modified_gmt":"2026-03-11T05:39:27","slug":"when-doctors-disagree-integrating-traditional-medicines-and-bifurcations-in-beneficence","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2026\/03\/11\/when-doctors-disagree-integrating-traditional-medicines-and-bifurcations-in-beneficence\/","title":{"rendered":"When doctors disagree: Integrating traditional medicines and bifurcations in beneficence"},"content":{"rendered":"

By Kathryn Muyskens<\/span><\/p>\n

Interest in integrating traditional medicine with biomedicine is growing worldwide. From policy endorsements by the <\/span>World Health Organization <\/span><\/a>to national healthcare reforms, \u201cintegrative medicine\u201d is increasingly framed as a pragmatic and culturally sensitive response to how patients actually seek care. Rather than choosing between medical traditions, many patients move fluidly between them.<\/span><\/p>\n

At first glance, this seems ethically reassuring. If different medical traditions all aim to benefit patients, why shouldn\u2019t they work together?<\/span><\/p>\n

Yet, this is <\/span>easier said than done.<\/span><\/a> There are real but often hidden differences in how different medical traditions understand what it means to benefit a patient in the first place. For an example, let\u2019s look at biomedicine and Traditional Chinese Medicine (TCM). On the surface, they share a common desire to benefit the wellbeing of their patients, all while quietly disagreeing about what that means in practice.<\/span><\/p>\n

These tensions are especially visible in healthcare systems where <\/span>medical pluralism<\/span><\/a> is the norm rather than the exception. In Singapore, for example, a large proportion of the population regularly consults TCM practitioners alongside biomedical doctors, and recent health policies explicitly embrace integrative care. TCM services are increasingly <\/span>offered within public hospitals,<\/span><\/a> and professional ethical codes governing both biomedical and TCM practitioners emphasize similar values: patient wellbeing, informed consent, and avoidance of harm.<\/span><\/p>\n

At first glance, this looks like ethical alignment. In practice, however, many patients do not disclose their use of traditional remedies to biomedical doctors, and clinicians from both traditions often feel ill-equipped to support truly collaborative care. These frictions suggest that shared ethical language alone is not enough to resolve deeper tensions.<\/span><\/p>\n

Thick traditions and thin assumptions<\/b><\/p>\n

One reason for this difficulty is that TCM and biomedicine are not merely collections of treatments. They are \u201cthick\u201d traditions, grounded in distinct ontological and epistemological commitments.<\/span><\/p>\n

Biomedicine largely understands health in naturalistic and mechanistic terms: disease is dysfunction, treatment aims at correcting pathological processes, and benefit is assessed through standardized outcomes such as survival rates or symptom reduction.<\/span><\/p>\n

TCM, by contrast, conceptualizes health as balance and harmony\u2014within the body and between the body and its environment. Concepts like <\/span>Qi<\/span><\/i> and organ systems do not map neatly onto biomedical anatomy or physiology. In line with this, healing is not understood as merely the elimination of disease, but is about restoring balance and supporting long-term vitality.<\/span><\/p>\n

This does not mean that TCM is ineffective or irrational. Some <\/span>TCM treatments have proven biomedical value<\/span><\/a>, and many patients experience meaningful benefits from TCM care. But the <\/span>logic of care<\/span><\/i>, from how diagnosis is made, to how treatments are selected, and how success is judged, differs in important ways.<\/span><\/p>\n

Bifurcations in beneficence\u00a0<\/b><\/p>\n

Both biomedical and TCM practitioners are professionally committed to beneficence. Yet this apparent alignment can be misleading. When two traditions use the same ethical term while embedding it in different worldviews, ethical consensus may be illusory.<\/span><\/p>\n

In biomedicine, beneficence is typically operationalized through evidence-based standards that prioritize generalizable outcomes. In TCM, beneficence is tied to individualized, context-sensitive judgments about balance, harmony, and long-term wellbeing.\u00a0<\/span><\/p>\n

This creates a faultline in cross-tradition clinical communication rooted in different understandings of beneficence: two sincere commitments to doing good that diverge in their understanding of what \u201cgood\u201d consists in and how it should be pursued.<\/span><\/p>\n

Crucially, this is not a problem that can be solved simply by generating more evidence or translating TCM concepts into biomedical terms. Doing so risks collapsing one tradition into the epistemic framework of the other, which risks further obscuring the very differences that generated the original ethical tension.<\/span><\/p>\n

A realistic way forward?<\/b><\/p>\n

Rather than smoothing over these differences with lip service to ethical codes or principles, a more promising approach for integration might be interprofessional collaboration grounded in the practice of epistemic virtues (Think humility, openness, respect and tolerance). It also requires honesty with patients about where and why clinicians from different traditions disagree, rather than presenting a false picture of consensus. Only by confronting these hidden sources of disagreement head on can integrative care genuinely serve patients who already live and seek healing across medical worlds.<\/span><\/p>\n

Article<\/b>: Bifurcations in Beneficence: Can Biomedicine and Traditional Chinese Medicine be Integrated?<\/a><\/span><\/p>\n

Author(s)<\/b>: Kathryn Muyskens [1], Zera Yingrui Te [2], Michael Dunn [1]<\/span><\/p>\n

Affiliation(s)<\/b>:<\/span><\/p>\n

    \n
  1. Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore<\/span><\/li>\n
  2. Yong Loo Lin School of Medicine, National University of Singapore<\/span><\/li>\n<\/ol>\n

    Conflict of Interest<\/b>: None to declare<\/span><\/p>\n

    Social Media<\/b>: <\/span>Kathryn Muyskens LinkedIn<\/span><\/a>; <\/span>Zera Te LinkedIn<\/span><\/a>; <\/span>Michael Dunn LinkedIn <\/span><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    By Kathryn Muyskens Interest in integrating traditional medicine with biomedicine is growing worldwide. From policy endorsements by the World Health Organization to national healthcare reforms, \u201cintegrative medicine\u201d is increasingly framed as a pragmatic and culturally sensitive response to how patients actually seek care. Rather than choosing between medical traditions, many patients move fluidly between them. […]<\/p>\n

    Read More…<\/a><\/p>\n","protected":false},"author":522,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8076,8057],"tags":[],"class_list":["post-4760","post","type-post","status-publish","format-standard","hentry","category-decision-making","category-medical-ethics"],"yoast_head":"\nWhen doctors disagree: Integrating traditional medicines and bifurcations in beneficence - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2026\/03\/11\/when-doctors-disagree-integrating-traditional-medicines-and-bifurcations-in-beneficence\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"When doctors disagree: Integrating traditional medicines and bifurcations in beneficence - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Kathryn Muyskens Interest in integrating traditional medicine with biomedicine is growing worldwide. From policy endorsements by the World Health Organization to national healthcare reforms, \u201cintegrative medicine\u201d is increasingly framed as a pragmatic and culturally sensitive response to how patients actually seek care. Rather than choosing between medical traditions, many patients move fluidly between them. 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