Trial of homeopathic medicine

[Do_Good]

Hi , I work at a hospice house.  We have and IAC aromatherapy nurse who brings in different "blends" for us to use.  Recently we received this email....     There is a new aromatherapy blend to try for hiccups called Hiccup Helper. It comes in a small squeeze bottle like the Mouth Gel. The directions are to place one drop on a clean or gloved finger and touch it to the roof of the mouth. you could squeeze one drop into a medicine cup to take into the patient's room. ....... Because this is new, we will heavily rely on your feedback!

I wonder if this is ethical.  I think this is experimenting on patients.  Also, no literature about side effects is given or ingredient list.   I wrote to my BON and they replied , in part, with this.... We are unable to advise on setting specific or client/patient specific practice questions

I was hoping the BON would give me something I could go to my boss with.  What would you do?

[UrbanHealthRN, BSN, RN]

When my aunt was on her hospice for her cancer, she was eating and drinking very little. Because of this, anything that she did eat or drink affected her body a lot more than usual, and we had to be careful. I remember she tried THC oil from a medical dispensary- all natural and supposed to help cancer patients, right?- she was sick as a dog after trying just a couple drops on her tongue. 

If someone offered these drops to my aunt with no ingredients list, I would be saying no. That poor woman was sick enough, she didn't need to feel worse. 

[pmabraham, BSN, RN]

Why would this be unethical if it can provide comfort?

Are you aware all of us are living experiments regarding medications?  For example, can you (the reader) guarantee that another human being with no known drug allergies will never have a side effect from an FDA-approved medication the doctor prescribed?

Can these holistic measures be considered an experiment?  Yes, from a point of view, but then, examine the above question about FDA-approved medications.

The goal of hospice is comfort that will hopefully enhance the quality of life for whatever life remains.  If the patient is okay with trying this new method, then do not cause them harm by preventing them -- do not be their nanny!

By the way, when we talk about ethics, nonmaleficence comes before beneficence in priority because you can have people who think they know better than anyone else. In their opinion, such and such would be beneficial and should be forced or viewed as malicious and then censored or otherwise unavailable.  Please don't let your personal opinions get in the way of the patient's comfort.

[UrbanHealthRN, BSN, RN]

pmabraham said:

Why would this be unethical if it can provide comfort?

Are you aware all of us are living experiments regarding medications?  For example, can you (the reader) guarantee that another human being with no known drug allergies will never have a side effect from an FDA-approved medication the doctor prescribed?

Can these holistic measures be considered an experiment?  Yes, from a point of view, but then, examine the above question about FDA-approved medications.

The goal of hospice is comfort that will hopefully enhance the quality of life for whatever life remains.  If the patient is okay with trying this new method, then do not cause them harm by preventing them -- do not be their nanny!

By the way, when we talk about ethics, nonmaleficence comes before beneficence in priority because you can have people who think they know better than anyone else. In their opinion, such and such would be beneficial and should be forced or viewed as malicious and then censored or otherwise unavailable.  Please don't let your personal opinions get in the way of the patient's comfort.

I don't think OP is letting personal opinion get in the way of patient comfort. As a nurse, it's a valid concern to say you don't know the ingredient list, you don't know possible side effects, and you don't know the efficacy of the homeopathic med being offered.

The FDA sets standards for the approval of medications, and we all know that many homeopathic meds don't go through the FDA or a similar approval process. I wouldn't want my loved one on hospice to be withheld comfort measures, but I also wouldn't want any harm done because of something we know very little about. 

Also, I looked up "IAC Aromatherapy" and it looks like some sort of business like Avon. It could be an ethical conflict to be bringing items to your work that you also personally make money off of. 

[pmabraham, BSN, RN]

The FDA did such a wonderful job with experimental injectables released as part of Operation Warp Speed, where the manufacturers are under no legal recourse for death or significant, often life-long, side effects.... NOT!

I stand by my point that the focus is THE PATIENT!  If the terminally ill patient wants to try something for THEIR comfort, perform informed consent and allow them the freedom!

[Tenebrae, BSN, RN]

Essential oils should not be taken orally and absolutely should not be administered by a nurse

If a patient wants to try this and can administer it themselves or has a family member that can administer it. Reluctantly fine

 

An organisation should not be making nurses administer this stuff

[pmabraham, BSN, RN]

"The directions are to place one drop on a clean or gloved finger and touch it to the roof of the mouth." -- hmmm.... one drop touched to the roof of the mouth... not swallowed or ingested.

Like all medications, informed consent is offered, and they have the right to refuse. Stand up to the organization if one feels strongly, but the focus should be on the dying patient and what they deem aids in their comfort.

[Do_Good]

UrbanHealthRN said:

I don't think OP is letting personal opinion get in the way of patient comfort. As a nurse, it's a valid concern to say you don't know the ingredient list, you don't know possible side effects, and you don't know the efficacy of the homeopathic med being offered.

The FDA sets standards for the approval of medications, and we all know that many homeopathic meds don't go through the FDA or a similar approval process. I wouldn't want my loved one on hospice to be withheld comfort measures, but I also wouldn't want any harm done because of something we know very little about. 

Also, I looked up "IAC Aromatherapy" and it looks like some sort of business like Avon. It could be an ethical conflict to be bringing items to your work that you also personally make money off of. 

Thanks for what your wrote!  You are right on.  I've been a hospice RN for years and am compassionate and caring.  I worked hard for my license and wouldn't want to jeopardize it in any way.  I also wouldn't want any harm to come to my patients.  

Another poster mentioned that essential oils should not be taken orally.  Other articles I've found say they are OK.   Since this is controversial I'd rather err on the side of safety and agree with you when you said, "I wouldn't want any harm done."  

My BON was of very little help.  In our state they don't put out opines and instead leave it up to each facility.  Very different from the state in which I initially licensed.

I ended up speaking with my boss about my concerns.

[FolksBtrippin, BSN, RN]

Do_Good said:

Thanks for what your wrote!  You are right on.  I've been a hospice RN for years and am compassionate and caring.  I worked hard for my license and wouldn't want to jeopardize it in any way.  I also wouldn't want any harm to come to my patients.  

Another poster mentioned that essential oils should not be taken orally.  Other articles I've found say they are OK.   Since this is controversial I'd rather err on the side of safety and agree with you when you said, "I wouldn't want any harm done."  

My BON was of very little help.  In our state they don't put out opines and instead leave it up to each facility.  Very different from the state in which I initially licensed.

I ended up speaking with my boss about my concerns.

Can you update us? What did your boss say?