Sham Surgery Trial Controls: Perspectives of Patients and Their Relatives

Swift, Teresa

doi:10.1525/jer.2012.7.3.15

Cited by 21 publications

(27 citation statements)

References 38 publications

(51 reference statements)

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“…Given that very large numbers of patients can be exposed to risky surgical innovations that have not been evaluated by clinical trials, the potential harm of "business as usual" is significant (Miller 2003). However, in view of these ethical considerations regarding sham surgery, and the fact that very few empirical studies have been carried out on lay attitudes to sham surgery (Swift 2012), we included a question asking respondents about the acceptability of using sham surgery in a clinical trial.…”

Section: Sham Surgerymentioning

confidence: 99%

Lay attitudes toward deception in medicine: Theoretical considerations and empirical evidence

Pugh

Kahane

Maslen

et al. 2015

AJOB Empirical Bioethics

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Background: There is a lack of empirical data on lay attitudes toward different sorts of deception in medicine. However, lay attitudes toward deception should be taken into account when we consider whether deception is ever permissible in a medical context. The objective of this study was to examine lay attitudes of U.S. citizens toward different sorts of deception across different medical contexts. Methods: A one-time online survey was administered to U.S. users of the Amazon "Mechanical Turk" website. Participants were asked to answer questions regarding a series of vignettes depicting different sorts of deception in medical care, as well as a question regarding their general attitudes toward truth-telling. Results: Of the 200 respondents, the majority found the use of placebos in different contexts to be acceptable following partial disclosure but found it to be unacceptable if it involved outright lying. Also, 55.5% of respondents supported the use of sham surgery in clinical research, although 55% claimed that it would be unacceptable to deceive patients in this research, even if this would improve the quality of the data from the study. Respondents supported fully informing patients about distressing medical information in different contexts, especially when the patient is suffering from a chronic condition. In addition, 42.5% of respondents believed that it is worse to deceive someone by providing the person with false information than it is to do so by giving the person true information that is likely to lead them to form a false belief, without telling them other important information that shows it to be false. However, 41.5% believed that the two methods of deception were morally equivalent. Conclusions: Respondents believed that some forms of deception were acceptable in some circumstances. While the majority of our respondents opposed outright lying in medical contexts, they were prepared to support partial disclosure and the use of placebos when it is in the patient's interests or when it is what the person would want. These results support the position that physicians should be allowed a greater degree of authority to make a professional judgment about whether deception might be morally warranted by the circumstances, provided that it doesn't involve outright lying.

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Section: Sham Surgerymentioning

confidence: 99%

Lay attitudes toward deception in medicine: Theoretical considerations and empirical evidence

Pugh

Kahane

Maslen

et al. 2015

AJOB Empirical Bioethics

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“…Such a trial would present its own ethical challenges with regard to the available evidentiary standard and the need to establish clinical equipoise. Even if equipoise could be established there would be issues of therapeutic misconception when patients enrolled in such a study are convinced they would receive treatment, and the resulting problems with achieving a fully informed consent [37]. …”

Section: Discussionmentioning

confidence: 99%

“Media, politics and science policy: MS and evidence from the CCSVI Trenches”

2013

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BackgroundIn 2009, Dr. Paolo Zamboni proposed chronic cerebrospinal venous insufficiency (CCSVI) as a possible cause of multiple sclerosis (MS). Although his theory and the associated treatment (“liberation therapy”) received little more than passing interest in the international scientific and medical communities, his ideas became the source of tremendous public and political tension in Canada. The story moved rapidly from mainstream media to social networking sites. CCSVI and liberation therapy swiftly garnered support among patients and triggered remarkable and relentless advocacy efforts. Policy makers have responded in a variety of ways to the public’s call for action.DiscussionWe present three different perspectives on this evolving story, that of a health journalist who played a key role in the media coverage of this issue, that of a health law and policy scholar who has closely observed the unfolding public policy developments across the country, and that of a medical ethicist who sits on an expert panel convened by the MS Society of Canada and the Canadian Institutes of Health Research to assess the evidence as it emerges.SummaryThis story raises important questions about resource allocation and priority setting in scientific research and science policy. The growing power of social media represents a new level of citizen engagement and advocacy, and emphasizes the importance of open debate about the basis on which such policy choices are made. It also highlights the different ways evidence may be understood, valued and utilized by various stakeholders and further emphasizes calls to improve science communication so as to support balanced and informed decision-making.

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“…A qualitative research study in the United Kingdom was conducted by Swift 17 and examined the perspectives of patients living with PD and their families. This study found that a small majority of interviewees felt that placebo controls were ethically acceptable.…”

Section: Conflicts or Confusionmentioning

confidence: 99%