2015/10/03 by Mark Alfano · 1 citation
Neuroscience · Medicine · Arts and Humanities · Psychology · #Pain Management and Placebo Effect #Empathy and Medical Education #Mental Health and Psychiatry #Beneficence #Deception #Paternalism #Autonomy #Psychology #Placebo #Framing (construction) #Informed consent #Social psychology #Psychotherapist #Medicine #Law #Alternative medicine #Political science
paper · doi:10.1080/15265161.2015.1074302
openalex publication_date 2015/10/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
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.