title: Touching ethics: assessing the applicability of ethical rules for safe touch in CAM--outcomes of a CAM (complementary and alternative medicine) practitioner survey in Israel.
abstract: BACKGROUND
  Recently, ethical guidelines regarding safe touch in CAM were developed in Israel. Publishing ethical codes does not imply that they will actually help practitioners to meet ethical care standards. The effectiveness of ethical rules depends on familiarity with the code and its content. In addition, critical self-examination of the code by individual members of the profession is required to reflect on the moral commitments encompassed in the code.
  
  
  METHODS
  For the purpose of dynamic self-appraisal, we devised a survey to assess how CAM practitioners view the suggested ethical guidelines for safe touch. We surveyed 781 CAM practitioners regarding their perspectives on the safe-touch code.
  
  
  RESULTS
  There was a high level of agreement with general statements regarding ethics pertaining to safe touch with a mean rate of agreement of 4.61 out of a maximum of 5. Practitioners concurred substantially with practice guidelines for appropriate touch with a mean rate of agreement of 4.16 out of a maximum of 5. Attitudes toward the necessity to touch intimate areas for treatment purposes varied with 78.6% of respondents strongly disagreeing with any notion of need to touch intimate areas during treatment. 7.9% neither disagreed nor agreed, 7.9% slightly agreed, and 7.6% strongly agreed with the need for touching intimate areas during treatment. There was a direct correlation between disagreement with touching intimate areas for therapeutic purposes and agreement with general statements regarding ethics of safe touch (Spearman r=0.177, p<0.0001), and practice guidelines for appropriate touch (r=0.092, p=0.012).
  
  
  CONCLUSIONS
  A substantial number of practitioners agreed with the code, although some findings regarding the need to touch intimate area during treatments were disturbing. Our findings can serve as a basis for ethical code development and implementation, as well as for educating CAM practitioners on the ethics of touch.
authors.affiliation: Department of Internal Medicine, Bnai-Zion Hospital, Haifa, Israel. eschiff@bezeqint.net
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
authors.forename: Margalit
authors.initials: M
authors.lastname: Shilo
authors.forename: Moti
authors.initials: M
authors.lastname: Levy
authors.forename: Leora
authors.initials: L
authors.lastname: Schachter
authors.forename: Na'ama
authors.initials: N
authors.lastname: Weitchner
authors.forename: Ofra
authors.initials: O
authors.lastname: Golan
authors.forename: Julie
authors.initials: J
authors.lastname: Stone
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D032781:Codes of Ethics; D000529:Complementary Therapies / Q000941:ethics* / Q000523:psychology; D003697:Delphi Technique; D005260:Female; D019538:Health Care Surveys; D006279:Health Maintenance Organizations; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D014110:Touch