To bring together an expert panel to consider the ethical issues that are associated with governmental coverage of traditional indigenous medicine in a colloquium to be held at the International Association of Bioethics annual conference in London in September, 2000. The panelists from South Africa, New Zealand and the USA will discuss their own countries' concerns and experiences in this area in an ethics context in an effort at mutual problem solving. Traditional Indian Medicine is often used by Native Americans in preference to, as validation of, and/or in conjunction with biomedicine1 2. Traditional practice meets the needs of American Indians arising from a different belief system and not met by scientific medicine3. Yet, only relatively recently has there been significant movement in legitimizing and integrating traditional indigenous care with the biomedical health care system or even any serious effort to evaluate its ifficacy. This absence of conventional framework about indigenous health care beliefs and practices confounds policy development for government-funded health care delivery which is available to almost all American Indian tribal members through various programs4, most notably the Indian Health Service (HIS). Since the 1975 passage of the Indian Self Determination and Education Assistance Act5, tribes are assuming increasing control of the federal programs on the reservations, including those for health care delivery. However, the tribes are not content to simply rearrange the elements of a health care system that lacks cultural relevance at the deepest level. They are re-thinking the components in light of their own communities' centuries-old beliefs about health and healing. From this re-thinking has emerged an intent to find a place for their own practitioners. The issues engendered from the emerging indigenous medicine claims on government-sponsored systems are intriguing and need to be addressed if the government is going to provide culturally sensitive, effective health care to its citizens. Due to the newness of considering merging traditional values and practices with biomedicine, and the predominantly oral tradition of indigenous practices, there is a paucity of work that addresses these concerns. It is, therefore, appropriate to cast a very wide net searching for any relevant expertise. The World Health Organization which has promoted the role of indigenous medicine in health since 1944, identified countries doing work with similar concerns and suggested the International Association of Bioethics (IAB) as a unique venue in which to bring together indigenous health care delivery experiences from other countries to begin the dialogue. An ethics forum will facilitate the recognition of the many conflicting values that underlie these issues and the IAB attendees are a particularly worthwhile constituency to involve in this issue as they represent a progressive and reflective element within health care and health care policy who can be articulate about any understanding they would achieve regarding indigenous peoples' health care agendas.
