Truth, Trust and Medicine

Jackson, Jennifer C.

doi:10.4324/9780203130452

Cited by 35 publications

(23 citation statements)

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“…Though these cases may be rare, in such exceptional circumstances it is generally recognized that the clinician may justifiably opt for paternalistic deception [15]. For this reason absolute deontological positions are rarely upheld in medical ethics without important qualifications [14].…”

Section: The Ethics Of Deceptive Placebosmentioning

confidence: 99%

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Placebos dans la pratique clinique : un aperçu éthique

Annoni

Miller

2014

Douleur analg

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The use of placebos in clinical settings raises a host of important ethical issues. On the one hand, ethical guidelines tend to categorically prohibit the clinical use of placebos because they require deception. On the other hand, a growing series of empirical studies has revealed that placebos can be clinically effective and are still widely used by health professionals. In this article we provide a synthetic overview of the ethical debate discussing: 1) the ethics of deceptive placebos; 2) the ethics of placebos without deception, and 3) the ethics of eliciting placebo responses without administering a traditional placebo.

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Section: The Ethics Of Deceptive Placebosmentioning

confidence: 99%

“…This means that deception is never morally permissible and that we have an absolute duty not to deceive others. Accordingly, supporters of deontological approaches tend to consider deceptive placebos as always unethical [14].…”

Section: The Ethics Of Deceptive Placebosmentioning

confidence: 99%

Placebos dans la pratique clinique : un aperçu éthique

Annoni

Miller

2014

Douleur analg

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“…Principle-based ethical theories do lend weight to truthfulness as such rather than to its consequences 19 – 23. However, the outcome of a practice, such as that of writing misleading certificates, can also be relevant to principle-based ethical theories that balance, for instance, concern for truth-telling and law-abidance against considerations of benevolence or personal integrity.…”

Section: Justified Behaviour?mentioning

confidence: 99%

“…Thus, if they were universally followed, they could not be universally followed, which involves a practical contradiction. For instance, if the maxim “make a false promise whenever it is convenient” were to be treated as a universal law, that would undermine the very practice of promise-making, since no one would have any reason to believe the promise-makers 21 23 24. Analogously, practices of writing misleading certificates might undermine the social practice of using certificates.…”

Section: Justified Behaviour?mentioning

confidence: 99%

Should physicians fake diagnoses to help their patients?

Helgesson

Lynøe

2008

J Med Ethics

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Are fake diagnoses and false or misleading certificates permissible means of helping patients? This question is examined in relation to four examples from Swedish health care: the sterilisation case, the asylum case, the virginity case, and the adoption case. We argue that both consequentialist and deontological ethical theories, to be reasonable, need to balance values, principles, and interests such as wellbeing, truthfulness, autonomy, personal integrity, trust in the medical profession, and abidance by national legislation. We conclude that it can be justifiable for physicians to fake diagnoses and write false or misleading certificates in order to help patients when not doing so has dire consequences. However, physicians must also consider the long-term effects of making exceptions to honest, non-deceitful behaviour based on the best empirical evidence available. Otherwise valuable social practices might erode and public confidence in physicians be threatened.

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“…It is therefore set first in the context of general understandings concerning the impact of public trust (or distrust) in the NHS (e.g., Davies and Lampell 1998;Harrison and Lachmann 1996;Mechanic 1986) in terms of its influence on both funding and accountability systems, and their subsequent success or otherwise in providing appropriate reassurance and effective action (Davies and Mannion 1999;Davies and Shields 1999;Smith 2001). It is also part of a growing awareness that frank open discussion is helpful in sustaining trust between patients and their doctors and nurses (Jackson 2001;Griffiths 2001). Thus, the paper seeks to develop an empirical understanding of the detailed role of trust in interpersonal interactions.…”

Section: Introductionmentioning

confidence: 97%

Achieving compliance in chronic illness management: illustrations of trust relationships between physicians and nutrition clinic patients

Dibben

Lean

2003

Health, Risk & Society

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This paper presents empirical research from a study of trust and co-operation between chronic illness patients and their physicians, conducted in nutrition clinics. The paper details models of trust and co-operative behaviour designed to aid interpretive analysis. The paper then presents an interpretive discussion of 16 examples from interactions observed between patients and their consultants at the initial visit and revisit stage of the illness management process in consecutive clinics. This illustrates some of the ways interpersonal trust development between patients and their physicians may affect health care delivery. The paper finds physicians appear to make in-clinic opportunities for building resilient trust relations with patients based on common understanding and experience, engendering more rapid patient compliance. This is further promoted by a contemporaneous positive focus on key issues, such as patient-perceived importance and patient-perceived self-competence, serving to lower patient co-operation thresholds. In the best instances, the combined effect is significant patient empowerment, and thus improved health care delivery as a result of the compliance thereby achieved. In addition, it is suggested the speed of trust development during the interactions is not commensurate with long term relationship sustainability, and suggests this as an explanation for, amongst others, failure to attend rates.

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Truth, Trust and Medicine

Cited by 35 publications

References 0 publications

Placebos dans la pratique clinique : un aperçu éthique

Placebos dans la pratique clinique : un aperçu éthique

Should physicians fake diagnoses to help their patients?

Achieving compliance in chronic illness management: illustrations of trust relationships between physicians and nutrition clinic patients

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