Placebo effects and informed consent

Journal article

Alfano, Mark. (2015). Placebo effects and informed consent. American Journal of Bioethics. 15(10), pp. 3 - 12. https://doi.org/10.1080/15265161.2015.1074302
AuthorsAlfano, Mark
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 (potentially among others) 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.

Keywordsplacebo; nocebo; informed consent; authorized concealment; authorized deception
Year2015
JournalAmerican Journal of Bioethics
Journal citation15 (10), pp. 3 - 12
PublisherRoutledge
ISSN1526-5161
Digital Object Identifier (DOI)https://doi.org/10.1080/15265161.2015.1074302
Scopus EID2-s2.0-84945131332
Page range3 - 12
Research GroupInstitute for Religion and Critical Inquiry
Publisher's version
File Access Level
Controlled
Place of publicationUnited Kingdom
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