The treatment of psychogenic movement disorders with suggestion is ethically justified.
Identifieur interne : 002967 ( Ncbi/Merge ); précédent : 002966; suivant : 002968The treatment of psychogenic movement disorders with suggestion is ethically justified.
Auteurs : Michel C F. Shamy [Canada]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- MESH :
- psychology : Movement Disorders.
- therapy : Movement Disorders.
- Decision Making, Ethics, Medical, Humans, Informed Consent, Personal Autonomy, Physician-Patient Relations, Suggestion.
Abstract
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.
DOI: 10.1002/mds.22911
PubMed: 20063430
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Shamy</name><affiliation wicri:level="4"><nlm:affiliation>University of Toronto, Division of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada. michel.shamy@utoronto.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Division of Neurology, Toronto Western Hospital, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="doi">10.1002/mds.22911</idno><idno type="RBID">pubmed:20063430</idno><idno type="pmid">20063430</idno><idno type="wicri:Area/PubMed/Corpus">001A35</idno><idno type="wicri:Area/PubMed/Curation">001A35</idno><idno type="wicri:Area/PubMed/Checkpoint">001552</idno><idno type="wicri:Area/Ncbi/Merge">002967</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The treatment of psychogenic movement disorders with suggestion is ethically justified.</title><author><name sortKey="Shamy, Michel C F" sort="Shamy, Michel C F" uniqKey="Shamy M" first="Michel C F" last="Shamy">Michel C F. Shamy</name><affiliation wicri:level="4"><nlm:affiliation>University of Toronto, Division of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada. michel.shamy@utoronto.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>University of Toronto, Division of Neurology, Toronto Western Hospital, Toronto, Ontario</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Decision Making</term><term>Ethics, Medical</term><term>Humans</term><term>Informed Consent</term><term>Movement Disorders (psychology)</term><term>Movement Disorders (therapy)</term><term>Personal Autonomy</term><term>Physician-Patient Relations</term><term>Suggestion</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Movement Disorders</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Movement Disorders</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Decision Making</term><term>Ethics, Medical</term><term>Humans</term><term>Informed Consent</term><term>Personal Autonomy</term><term>Physician-Patient Relations</term><term>Suggestion</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">20063430</PMID><DateCreated><Year>2010</Year><Month>03</Month><Day>03</Day></DateCreated><DateCompleted><Year>2010</Year><Month>06</Month><Day>02</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>25</Volume><Issue>3</Issue><PubDate><Year>2010</Year><Month>Feb</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. 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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. 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