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001-es BibID:	BIBFORM077561
Első szerző:	Gajdos Ágoston (pszichiáter szakorvos)
Cím:	Frontiers of placebo surgery - bioethical questions and concerns of an innovative treatment method in psychiatry / Ágoston, Gajdos
Dátum:	2014
Megjegyzések:	The use of placebo has been always a problematic issue among medical experts with a fully biological approach, and among patients, whose demands are setting the sight of EBM high nowadays either. The need for clarification, what is placebo and what is not, is a streaming need in everyday scientific research, because the use of placebos is the goldstandard when testing medical therapy. Although he idea of placebo surgery is known since the 1930's, only a few trials were conducted worldwide. Since the results of sham surgery and real operation can be significantly alike, the power of placebo playing role during the fake intervention should be taken much more into consideration. Indeed, examining sham surgery from a very specific angle may help an observer to identify new aspects of the placebo effect. This presentation aims to offer new avenues for reflection by telling a case history of a placebo intervention performed on a psychiatric patient. Using placebo surgery in psychiatry raises several ethical questions but it has not been attracting discussion until this moment among the ethicist. The partial success of this case might be an initiation for further thinking to work out standards of a semi-assisted non-invasive psychodrama, that is how the procedure was named. Reducing mental symptoms via placebo effect does not share new insights, as is it a common experience in clinical practice. The novelty of this case is that it happened theoretically on the borderlands of two different approaches: the highly technical evidence based one and the most commonly tacitly rejected field of the 'existence based' placebo effect. The Declaration of Helsinki adresses the the tasks someone has when using an innovative form of therapy. Such as in other countries around the world, surgeons have the most possibility to introduce new discoveries, e.g. new operating techniques. Psychiatry is still suffering from shadows of misusing lobotomy, insuline coma and electroconvulsive therapy in the past. Despite the community of bioethicist is not really open to sharing sham surgery practices, a well established explanation of it may give a useful tool into the hands of psychiatric experts facing patients resistent to classical therapy. An in-depht theoretical analysis could shed light on the background mechanisms of the sham surgery. The psychodramatic explanation highlights more underlying drivers. Putting a patient into a dramatized situation, where he/she is playing a specific role, would expose him/her to harmful psychic rebounds or even to some physical impairments representing nocebo effect. What if the patient regains his/her normal mental functions after a sham surgery and claims for previosly lost right of capacity? Who is responsible for the documentation of a sham surgery or is it even possible to find a legislation regulating such a procedure? Opening a discourse about such questions should help sham surgery to become a valuable therapeutic regime in psychiatry.
ISBN:	ISBN: 978-963-473-728-5
Tárgyszavak:	Orvostudományok Elméleti orvostudományok előadáskivonat
Megjelenés:	Bioethics and Biopolitics. Proceedings of the 28th European Conference on Philosophy of Medicine and Health Care / ed. Bert Gordijn, Péter Kakuk, Attila Bánfalvi. - p. 11-12. -
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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