David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Ezio Di Nucci
Jonathan Jenkins Ichikawa
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medical Ethics 39 (3):166-170 (2013)
Major depressive disorder is not only the most widespread mental disorder in the world, it is a disorder on the rise. In cases of particularly severe forms of depression, when all other treatment options have failed, the use of electroconvulsive therapy (ECT) is a recommended treatment option for patients. ECT has been in use in psychiatric practice for over 70 years and is now undergoing something of a restricted renaissance following a sharp decline in its use in the 1970s. Despite its success in treating severe depression there is continued debate as to the effectiveness of ECT: in some studies, it is argued that ECT is marginally more effective than sham ECT. In addition, there is still no clear explanation of how ECT works; among the range of hypotheses proposed it is claimed that ECT may work by harnessing placebo effects. In light of the uncertainties over the mechanism of action of ECT and given the risk of serious side effects that ECT may produce, I contend that the process of informed consent must include comprehensive accounts of these uncertainties. I examine the possible consequences of providing adequate information to potential ECT patients, including the consideration that ECT may still prove to be effective even if physicians are open about the possibility of it working as a placebo. I conclude that if we value patient autonomy as well as the professional reputation of medical practitioners, a fuller description of ECT must be provided to patients and their carers
|Keywords||info:mesh/Mental Competency info:mesh/United States info:mesh/History, 20th Century info:mesh/Informed Consent info:mesh/Decision Making info:mesh/Clinical Trials as Topic info:mesh/Cognition Disorders info:mesh/Deception info:mesh/Depressive Disorder, Major info:mesh/Great Britain info:mesh/Placebo Effect info:mesh/Uncertainty info:mesh/Humans info:mesh/History, 21st Century info:mesh/Italy info:mesh/Personal Autonomy info:mesh/Memory Disorders info:mesh/Truth Disclosure info:mesh/Electroconvulsive Therapy Humans Memory Disorders Uncertainty Truth Disclosure Deception Mental Competency Paternalism Decision Making Personal Autonomy Cognition Disorders Depressive Disorder, Major Electroconvulsive Therapy Placebo Effect Informed Consent History, 20th Century History, 21st Century United States Great Britain Italy Clinical Trials as Topic info:mesh/Paternalism|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
A. Gold & P. Lichtenberg (2014). The Moral Case for the Clinical Placebo. Journal of Medical Ethics 40 (4):219-224.
Jeremy Howick (forthcoming). The Relativity of ‘Placebos’: Defending a Modified Version of Grünbaum’s Definition. Synthese:1-34.
C. Blease (2014). The Duty to Be Well-Informed: The Case of Depression. Journal of Medical Ethics 40 (4):225-229.
Robert Torrance (2015). Informed Consent and ECT: How Much Information Should Be Provided? Journal of Medical Ethics 41 (5):371-374.
Similar books and articles
C. Blease (2013). Electroconvulsive Therapy: The Importance of Informed Consent and 'Placebo Literacy'. Journal of Medical Ethics 39 (3):173-174.
J. L. Mommaerts & Dirk Devroey (2012). The Placebo Effect: How the Subconscious Fits In. Perspectives in Biology and Medicine 55 (1):43-58.
Piotr Zaborowski & Adam Górski (2004). Informed Consent and the Use of Placebo in Poland: Ethical and Legal Aspects. Science and Engineering Ethics 10 (1):167-178.
Shlomo Cohen (2014). The Nocebo Effect of Informed Consent. Bioethics 28 (3):147-154.
Jan C. Joerden (2004). Placebo and Criminal Law. Science and Engineering Ethics 10 (1):65-72.
Prashant Gajwani, David Muzina, Kerning Gao & Joseph R. Calabrese (2006). Awareness Under Anesthesia During Electroconvulsive Therapy Treatment. Journal of ECT 22 (2):158-159.
Robert J. Connelly (1991). Nursing Responsibility for the Placebo Effect. Journal of Medicine and Philosophy 16 (3):325-341.
Mary Stefanazzi (2013). Is Electroconvulsive Therapy (ECT) Ever Ethically Justified? If so, Under What Circumstances. HEC Forum 25 (1):79-94.
James Giles (2002). Electroconvulsive Therapy and the Fear of Deviance. Journal for the Theory of Social Behaviour 32 (1):61–87.
Gunnel Elander & Göran Hermerén (1995). Placebo Effect and Randomized Clinical Trials. Theoretical Medicine and Bioethics 16 (2).
Deborah Bowman (2011). Informed Consent: A Primer for Clinical Practice. Cambridge University Press.
Olov Lindahl & Lars Lindwall (1982). Is All Therapy Just a Placebo Effect? Theoretical Medicine and Bioethics 3 (2):255-259.
Jukka Varelius (2012). On Taylor's Justification of Medical Informed Consent. Bioethics 26 (4):207-214.
A. T. Nuyen (2007). Knowing the Unknown and Informed Consent. International Journal of Applied Philosophy 21 (2):213-223.
Ellen B. Braaten & Michael M. Handelsman (1997). Client Preferences for Informed Consent Information. Ethics and Behavior 7 (4):311 – 328.
Added to index2012-10-05
Total downloads11 ( #326,420 of 1,934,567 )
Recent downloads (6 months)2 ( #269,381 of 1,934,567 )
How can I increase my downloads?