When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect

American Journal of Bioethics 17 (6):36-42 (2017)

Abstract
Nocebo effects occur when an adverse effect on the patient arises from the patient's own negative expectations. In accordance with informed consent, providers often disclose information that results in unintended adverse outcomes for the patient. While this may adhere to the principle of autonomy, it violates the doctrine of “primum non nocere,” given that side-effect disclosure may cause those side effects. In this article we build off previous work, particularly by Wells and Kaptchuk and by Cohen :3–11.[Taylor & Francis Online], [Web of Science ®] [Google Scholar]), to suggest ethical guidelines that permit nondisclosure in the case when a nocebo effect is likely to occur on of the basis of nonmaleficence. We accept that that autonomy vis-à-vis informed consent must be forestalled, but salvage much of its role by elaborating a practical clinical approach to postencounter follow-up. In doing so, we reconcile a clinically practicable process of determining conditions of disclosure with long-standing ethical commitments to patients.
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DOI 10.1080/15265161.2017.1314042
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References found in this work BETA

Autonomy and Trust in Bioethics.Onora O'Neill - 2002 - Cambridge University Press.
Nudging and Informed Consent.Shlomo Cohen - 2013 - American Journal of Bioethics 13 (6):3-11.
The Nocebo Effect of Informed Consent.Shlomo Cohen - 2014 - Bioethics 28 (3):147-154.

View all 13 references / Add more references

Citations of this work BETA

Preventing Nocebo Effects of Informed Consent Without Paternalism.Shlomo Cohen - 2017 - American Journal of Bioethics 17 (6):44-46.

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