The Ethics of Open-Label Placebos in Pediatrics
2017; American Academy of Pediatrics; Volume: 140; Issue: 2 Linguagem: Inglês
10.1542/peds.2016-4328
ISSN1098-4275
AutoresBrit Trogen, Arthur L. Caplan, Perri Klass,
Tópico(s)Pediatric Pain Management Techniques
Resumo* Abbreviation: ADHD — : attention-deficit/hyperactivity disorder Physicians have long debated the ethics of prescribing placebos as medical therapeutics. Placebos (sham treatments such as sugar pills or saline injections) are thought to elicit improvements in clinical outcomes by mimicking medical therapies, thereby improving patients' expectations of getting better.1 While the placebo effect plays a role in virtually every clinical intervention, the use of placebos as stand-alone treatments within medicine has largely been discouraged due to concerns about patient deception. Until recently, it was thought that for the placebo effect to emerge, the patient must be unaware they are receiving an inert substance. That physicians might mislead or deceive their patients, even for the sake of a clinical benefit, was generally viewed as morally unacceptable in the post–World War II era of informed consent and patient autonomy. Over the past decade, however, concerns that placebos violate patient autonomy have been addressed by the development of “open-label placebos,” treatments prescribed with full transparency and patient awareness. Patients offered an open-label placebo for the management of a given medical condition are informed that the substance is completely inert with no active drug component. Patients also are told, however, that such placebos have been found to produce benefits in individuals with their condition, … Address correspondence to Brit Trogen, MS, New York University School of Medicine, 550 1st Ave, New York, NY 10016-1126. E-mail: brit.trogen{at}nyumc.org
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