期刊
MOVEMENT DISORDERS
卷 25, 期 3, 页码 260-264出版社
WILEY
DOI: 10.1002/mds.22911
关键词
ethics; suggestion; treatment; psychogenic movement disorders
资金
- Royal College of Physicians and Surgeons of Canada
- Royal College of Physicians and Surgeons of Canada K.J.R. Wightman Award for Resident Research in Ethics
Recent developments in our understanding of psychogenic movement disorders have not yet led to advances in treatment. A potentially beneficial treatment strategy is suggestion, the voluntary use by the physicians of techniques that introduce into the patient's mind a belief that he or she will be healed. Principalism, the dominant school of contemporary medical ethics, holds that the use of suggestion is not ethically justifiable because it undermines patient autonomy and degrades the doctor-patient relationship. However, evidence from a variety of sources (neuroimaging, anecdote, expert opinion, randomized controlled trials, and meta-analysis) supports the efficacy of suggestion as a treatment for psychogenic movement disorders. When issues of choice, consent, deceit, disclosure, and decision-making are analyzed from the perspective of an ethics of care, we see that suggestion may enhance patient autonomy and does not violate the trust between doctors and their patients. I conclude that suggestion is therefore an ethically justifiable treatment for patients with psychogenic movement disorders. (C) 2010 Movement Disorder Society
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