In children with mild or moderate asthma, the addition of chiropractic spinal manipulation to usual medical care provided no benefit.

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Consumer enthusiasm for complementary and alternative medicine presents complex challenges for conventional Western biomedically dominated health care systems and for those who practice within them. In particular, this trend forces new ethical dilemmas related to how we create consensus about the nature of ethical clinical practice and what constitutes evidence sufficient for public health policy. In this paper, we examine the historical context into which complementary and alternative medicine has been introduced, and consider the ethical and scientific challenges with which it confronts mainstream health systems.