Unethical informed consent caused by overlooking poorly measured nocebo effects

Bibliographic Data

ID21515135
AuthorsJeremy Howick (0000-0003-0280-7206, University of Oxford, corresponding author)
Year2021
Volume47
Issue9
Pages590-594
Publication date2021-09-01
Open AccessNo
TypeARTICLE
VenueJournal of Medical Ethics (JOURNAL)
Journal identifiersISSN: 0306-6800 • E-ISSN: 1473-4257
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/medethics-2019-105903
PMID32063581
OpenAlexW3006495587
LanguageEN
Citations received1
References cited41

Unlike its friendly cousin the placebo effect, the nocebo effect (the effect of expecting a negative outcome) 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 (in clinical trials and clinical practice) 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 (ethical) informed consent and communicating intervention risks with patients

Alternative medicine · Autonomy · Bioethics · Harm · Informed consent · Nocebo · Nocebo Effect · Placebo · Political science · Psychiatry · Psychological intervention · Psychotherapist · Empathy and Medical Education · Law · Medicine · Pain Management and Placebo Effect · Pediatric Pain Management Techniques · Psychology · Social Psychology

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