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评论:伤害、真相与反安慰剂效应。

Commentary: Harm, Truth, and the Nocebo Effect.

作者信息

Ho Dien

出版信息

Camb Q Healthc Ethics. 2020 Apr;29(2):236-245. doi: 10.1017/S0963180119001038.

Abstract

Nocebo effects occur when an individual experiences undesirable physiological reactions caused by doxastic states that are not a treatment's core or characteristic features.1 As Scott Gelfand2 points out, there are numerous studies that have shown that the disclosure of a treatment's side effects to a patient increases the risk of the side effects. From an ethical point of view, nocebo effects caused by the disclosures of side effects present a challenging problem. On the one hand, clinicians' duty to inform patients of the consequences (including possible side effects) of their treatments is critical in ensuring that patients' autonomy is respected. Patients cannot act autonomously if relevant information is withheld from them (without their consent, perhaps). On the other hand, clinicians also ought to minimize harm to patients.

摘要

当个体经历由并非治疗的核心或特征性特征的信念状态引起的不良生理反应时,就会出现反安慰剂效应。正如斯科特·盖尔范德所指出的,有大量研究表明,向患者披露治疗的副作用会增加副作用发生的风险。从伦理角度来看,由副作用披露引起的反安慰剂效应提出了一个具有挑战性的问题。一方面,临床医生有责任告知患者其治疗的后果(包括可能的副作用),这对于确保尊重患者的自主权至关重要。如果向患者隐瞒相关信息(或许未经他们同意),患者就无法自主行动。另一方面,临床医生也应该尽量减少对患者的伤害。

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