Placebo Effects and Informed Consent

American Journal of Bioethics 15 (10):3-12 (2015)
Authors
Mark Alfano
Delft University of Technology
Abstract
The concepts of placebos and placebo effects refer to extremely diverse phenomena. I recommend dissolving the concepts of placebos and placebo effects into loosely related groups of specific mechanisms, including expectation-fulfillment, classical conditioning, and attentional-somatic feedback loops. If this approach is on the right track, it has three main implications for the ethics of informed consent. First, because of the expectation-fulfillment mechanism, the process of informing cannot be considered independently from the potential effects of treatment. Obtaining informed consent influences the effects of treatment. This provides support for the authorized concealment and authorized deception paradigms, and perhaps even for outright deceptive placebo use. Second, doctors may easily fail to consider the potential benefits of conditioning, leading them to misjudge the trade-off between beneficence and autonomy. Third, how attentional-somatic feedback loops play out depends not only on the content of the informing process but also on its framing. This suggests a role for libertarian paternalism in clinical practice.
Keywords placebo  informed consent  medical ethics  bioethics
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DOI 10.1080/15265161.2015.1074302
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References found in this work BETA

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
The Silent World of Doctor and Patient.Jay Katz - 1984 - Johns Hopkins University Press.
A Duty to Deceive: Placebos in Clinical Practice.Bennett Foddy - 2009 - American Journal of Bioethics 9 (12):4-12.

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Citations of this work BETA

Destigmatising the Placebo Effect.Mark H. Arnold, Damien G. Finniss & Ian Kerridge - 2015 - American Journal of Bioethics 15 (10):21-23.
Placebo, Nocebo, Informed Consent, and Moral Technologies.Sabine Roeser - 2015 - American Journal of Bioethics 15 (10):15-17.

View all 8 citations / Add more citations

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Autonomy, Consent and the Law.Sheila McLean - 2010 - Routledge-Cavendish.

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