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When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect.
Am J Bioeth 2017; 17(6):36-42AJ

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 (2012) and by Cohen (2013), 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.

Authors+Show Affiliations

a Oakland University William Beaumont School of Medicine.a Oakland University William Beaumont School of Medicine.a Oakland University William Beaumont School of Medicine.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28537834

Citation

Fortunato, John T., et al. "When Respecting Autonomy Is Harmful: a Clinically Useful Approach to the Nocebo Effect." The American Journal of Bioethics : AJOB, vol. 17, no. 6, 2017, pp. 36-42.
Fortunato JT, Wasserman JA, Menkes DL. When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect. Am J Bioeth. 2017;17(6):36-42.
Fortunato, J. T., Wasserman, J. A., & Menkes, D. L. (2017). When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect. The American Journal of Bioethics : AJOB, 17(6), pp. 36-42. doi:10.1080/15265161.2017.1314042.
Fortunato JT, Wasserman JA, Menkes DL. When Respecting Autonomy Is Harmful: a Clinically Useful Approach to the Nocebo Effect. Am J Bioeth. 2017;17(6):36-42. PubMed PMID: 28537834.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - When Respecting Autonomy Is Harmful: A Clinically Useful Approach to the Nocebo Effect. AU - Fortunato,John T, AU - Wasserman,Jason Adam, AU - Menkes,Daniel Londyn, PY - 2017/5/25/entrez PY - 2017/5/26/pubmed PY - 2019/5/23/medline KW - disclosure KW - ethics KW - informed consent KW - nocebo effect KW - placebo effect SP - 36 EP - 42 JF - The American journal of bioethics : AJOB JO - Am J Bioeth VL - 17 IS - 6 N2 - 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 (2012) and by Cohen (2013), 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. SN - 1536-0075 UR - https://www.unboundmedicine.com/medline/citation/28537834/When_Respecting_Autonomy_Is_Harmful:_A_Clinically_Useful_Approach_to_the_Nocebo_Effect_ L2 - http://www.tandfonline.com/doi/full/10.1080/15265161.2017.1314042 DB - PRIME DP - Unbound Medicine ER -