Graduate studies at Western
Neuroethics 3 (2):95-98 (2010)
|Abstract||Psychogenic non epileptic seizures (PNES) are clinical events of psychological nature. Video-electroencephalography monitoring (V-EEGM) is a valuable method for the diagnosis of PNES and may be combined with provocative tests to induce seizures. The use of placebo in provocative tests for the diagnosis of PNES is controversial because of associated deception, and contrasts with the use of truly decreasing epileptogenic threshold techniques such as hyperventilation and photo stimulation. We present a clinical case of a pregnant woman with a past history of refractory epilepsy, admitted in the obstetric department due to unremitting seizures. In this clinical context, non-deceiving provocative tests such as hyperventilation and photo stimulation could be potentially harmful, nevertheless, the use of intravenous saline injection presented as a safer alternative to diagnose PNES and hence obviate an urgent caesarean. This case illustrates a disproportionate risk of causing harm when telling the truth, in comparison with the benefit of avoiding such risk, although deceiving the patient. This is a clinical example of how considerations concerning the use of placebo must be evaluated in an individual basis.|
|Keywords||Psychogenic non epileptic seizures Video-electroencephalography monitoring Provocative tests|
|Categories||categorize this paper)|
|Through your library||Configure|
Similar books and articles
David B. Resnik (1995). To Test or Not to Test: A Clinical Dilemma. Theoretical Medicine and Bioethics 16 (2).
Daniel Groll (2011). What You Don't Know Can Help You: The Ethics of Placebo Treatment. Journal of Applied Philosophy 28 (2):188-202.
Franklin G. Miller & Howard Brody (2002). What Makes Placebo-Controlled Trials Unethical? American Journal of Bioethics 2 (2):3 – 9.
Andrew Turner (2012). 'Placebos' and the Logic of Placebo Comparison. Biology and Philosophy 27 (3):419-432.
G. Testylier, L. Tonduli & G. Lallement (1999). Implication of Gamma Band in Soman-Induced Seizures. Acta Biotheoretica 47 (3-4).
Atsushi Asai & Yasuhiro Kadooka (2013). Reexamination of the Ethics of Placebo Use in Clinical Practice. Bioethics 27 (4):186-193.
Michel Le Van Quyen & Claire Petitmengin (2002). Neuronal Dynamics and Conscious Experience: An Example of Reciprocal Causation Before Epileptic Seizures. [REVIEW] Phenomenology and the Cognitive Sciences 1 (2):169-180.
Anneliese A. Pontius (2003). From Volitional Action to Automatized Homicide: Changing Levels of Self and Consciousness During Partial Limbic Seizures. Aggression and Violent Behavior 8 (5):547-561.
Added to index2010-03-13
Total downloads5 ( #170,343 of 738,450 )
Recent downloads (6 months)0
How can I increase my downloads?