Journal of Medical Ethics 47 (9):590-594 (2021)

Jeremy Howick
Oxford University
Unlike its friendly cousin the placebo effect, the nocebo effect has been almost ignored. Epistemic and ethical confusions related to its existence have gone all but unnoticed. Contrary to what is often asserted, adverse events following from taking placebo interventions are not necessarily nocebo effects; they could have arisen due to natural history. Meanwhile, ethical informed consent has centred almost exclusively on the need to inform patients about intervention risks with patients to preserve their autonomy. Researchers have failed to consider the harm caused by the way in which the information is conveyed. In this paper, I argue that the magnitude of nocebo effects must be measured using control groups consisting of untreated patients. And, because the nocebo effect can produce harm, the principle of non-maleficence must be taken into account alongside autonomy when obtaining informed consent and communicating intervention risks with patients. There are no data in this work.
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DOI 10.1136/medethics-2019-105903
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References found in this work BETA

Placebo Effects and Informed Consent.Mark Alfano - 2015 - American Journal of Bioethics 15 (10):3-12.
A Duty to Deceive: Placebos in Clinical Practice.Bennett Foddy - 2009 - American Journal of Bioethics 9 (12):4-12.
Philosophy of Too Much Medicine Conference Report.Susanne Uusitalo & Jeremy Howick - 2018 - Journal of Evaluation in Clinical Practice 24 (5):1011-1012.

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