THE ATTITUDES OF PATIENTS AND PHYSICIANS TOWARDS PLACEBO-TREATMENT - A COMPARATIVE-STUDY
THE ATTITUDES OF PATIENTS AND PHYSICIANS TOWARDS PLACEBO-TREATMENT - A COMPARATIVE-STUDY
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DOI：
10.1016/0277-9536(93)90037-5
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发表时间：
1993-03-01
影响因子：
5.4
通讯作者：
SANDLUND, M
中科院分区：
文献类型：
--
作者：
LYNOE, N;MATTSSON, B;SANDLUND, M
在临床实践中，安慰剂治疗可以是为了顺应患者的意愿，也可以是为了做好事而不是造成伤害。在前一种情况下，程序可能符合病人的利益，但却与医疗专业的利益相冲突。在后一种情况下，该程序的前提是，在大多数情况下，患者没有被告知治疗的性质；这种类型的程序可能会危及相互信任的医患关系。因此。调查患者和医生认为他们可以接受安慰剂治疗的存在和家长式态度，以及在哪些特定情况下是有意义的。为了阐明这一问题，我们编制了一份调查问卷，围绕三个案例建立，这些案例使安慰剂治疗和家长式行为成为问题。调查问卷发放给了100名患者和100名医生。83名患者和94名医生进行了回答。结果表明，患者和医生并不会自动遵循特定的群体兴趣。医生更倾向于尊重患者拒绝治疗的选择，而不是患者倾向于尊重医生的职业自主权。患者在他们的判断中似乎比医生更具家长式作风，但我们不能排除医生的回答反映了安慰剂治疗代表着一种社会不受欢迎的行为的可能性。我们得出结论，对参与者视角的理论和规范分析应该得到实证研究的补充。需要对定性方法进行更多的研究，以验证我们的结果，并阐明不一致的反应和特定判断背后的伦理原则。
Placebo treatment in clinical practice can be given either in order to comply with the wishes of the patient, or with the purpose of doing good and not causing harm. In the former instance, the procedure may be in accordance with the interests of the patient, yet be in conflict with the interests of the medical profession. In the latter instance, the procedure presupposes that in most cases the patient has not been informed of the nature of the treatment; this type of procedure may jeopardize a trusting patient-doctor relationship. Therefore. it is of interest to investigate both the exent to which patients and physicians feel they can accept placebo treatment and a paternalistic attitude, and in which particular situations.In order to shed some light on this matter, we compiled a questionnaire built around three case histories which problematize placebo treatment and paternalistic acts. The questionnaire was distributed to 100 patients and 100 physicians. 83 patients and 94 physicians responded.The results show that patients and physicians do not automatically follow specific group interests. Physicians are more inclined to respect the patient's option to refuse medical treatment than the patients are inclined to respect a physician's professional autonomy. Patients appear more to be paternalistic in their judgements than physicians, but one cannot rule out the possibility that the answers of the physicians reflect the fact that placebo treatment represent a socially undesirable behaviour.We conclude that theoretical and normative analyses of the perspective of the actors ought to be supplemented by empirical research. More studies of a qualitative approach are needed in order to validate our results and to illuminate inconsistent responses and the ethical principles which lie behind particular judgements.