Defining alternative health care and the recording of associated adverse events and harm remains problematic. This Canadian study aimed to establish and classify riskassociated alternative health practices in a Delphi study undertaken with an interdisciplinary panel of 17 health experts in 2020. It provides a new functional definition of alternative health care and an initial taxonomy of risk-associated alternative health care practices. A number of risk-associated practices were identified and categorized into general practices that conflict with biomedical care or largely untested therapies, alternative beliefs systems, physical manipulative alternative therapies, and herbal and nutritional supplements. Some risk significant harms including major physical injuries or even death. The lack of systematic methods for recording adverse events in alternative health care makes establishing the frequency of such events challenging. However, it is important that people engaging with alternative health care understand they are not necessarily risk-free endeavours, and what those risks are.

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Last month, the authors examined bias and the need for mediators' essential mission to preserve the parties' self‐determination in the face of capacity issues. They conclude their four‐part series this month focusing on accommodations and support for parties that need it. The first three parts of the series can be found at “Biases, Accommodations, and the Process Details for Americans with Disabilities Act Mediation,” 41 Alternatives 55 (April 2023) (available at https://bit.ly/3A4LH4K); “Focusing on the Neutral's Role in Setting Up Americans with Disabilities Act Mediation,” 41 Alternatives 39 (March 2023) (available at https://bit.ly/3EEnWDj), and “ADA Mediation, Updated: Revisiting 30 Years of Disabilities Practice,” 41 Alternatives 19 (February 2023) (available at bit.ly/3jTICQE) (which includes a box on Methodology and a Mediation Capacity Resource List sidebar).

This article presents the results from a qualitative study that explored how legislation in British Columbia, intended to protect vulnerable adults from harm, is implemented in practice. The legislation contains guiding principles that require the least restrictive and minimally intrusive form of support or intervention be used and that the adult’s wishes be respected. Sixteen professionals who work as elder abuse responders in British Columba participated in this study through interviews and a focus group. Fifteen of the study participants were social workers. Grounded theory method was used, and themes were identified. The first theme reveals that responders prefer to obtain older adult consent to service provider involvement, rather than forcing compliance by using statutory authority. The second theme reveals that responders may not be able to intervene in a minimally intrusive manner because of resource shortages and organizational structural issues. These findings have human rights and social justice implications.

After four minichapters last month, this article views capacity issues through a case study, the application of the Model Standards of Conduct for Mediators, and some of the factors that limit a participant's ability to mediate.