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安慰剂治疗、知情同意与“错误观念的束缚”

Placebo treatments, informed consent and 'the grip of a false picture'.

作者信息

Glackin Shane Nicholas

出版信息

J Med Ethics. 2015 Aug;41(8):669-72. doi: 10.1136/medethics-2014-102332. Epub 2014 Oct 16.

Abstract

It is widely supposed that the prescription of placebo treatments to patients for therapeutic purposes is ethically problematic on the grounds that the patient cannot give informed consent to the treatment, and is therefore deceived by the physician. This claim, I argue, rests on two confusions: one concerning the meaning of 'informed consent' and its relation to the information available to the patient, and another concerning the relation of body and mind. Taken together, these errors lead naturally to the conclusion that the prescription of placebos to unwitting patients is unethical. Once they are dispelled, I argue, we can see that providing 'full' information against a background of metaphysical confusion may make a patient less informed and that the 'therapeutic' goal of relieving the patient of such confusions is properly the duty of the philosopher rather than the physician. Therapeutic placebos therefore do not violate the patient's informed consent or the ethical duties of the doctor.

摘要

人们普遍认为,出于治疗目的给患者开安慰剂在伦理上存在问题,理由是患者无法对该治疗给予知情同意,因此受到了医生的欺骗。我认为,这种说法基于两种混淆:一种涉及“知情同意”的含义及其与患者可获得信息的关系,另一种涉及身心关系。综合起来,这些错误自然会得出这样的结论:给不知情的患者开安慰剂是不道德的。我认为,一旦消除这些混淆,我们就会明白,在形而上学混乱的背景下提供“完整”信息可能会使患者了解的情况更少,而消除患者此类困惑的“治疗”目标恰是哲学家而非医生的职责。因此,治疗性安慰剂并未侵犯患者的知情同意权,也未违背医生的伦理职责。

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