Official websites use. Share sensitive information only on official, secure websites. Recent research into the placebo effect has implications for the ethics of shared decision-making SDM. The older biomedical model views SDM as affecting which therapy is chosen, but not the nature or likelihood of any health outcomes produced by the therapy.
Several practical strategies mitigate this tension and promote respect for autonomous decision-making while still utilizing the therapeutic potential of SDM. Recently, the science of the placebo has achieved greater if still grudging acceptance. The term SDM is often used inconsistently. SDM may and should be employed in life-threatening disease, where biomedical factors far outweigh placebo effects in determining the outcome.
Nevertheless, physicians frequently encounter treatment decisions involving chronic and self-limited illnesses. SDM is generally interpreted according to a biomedical model. The SDM process starts with the scientific data on the nature and likelihood of the benefits and harms associated with each treatment.
The physician explains these facts and then assists the patient in choosing the option that seems most in accord with her values. Consider a patient with chronic low back pain. SDM requires that the physician explain the many treatment options, including perhaps surgery, medications, physical therapy, massage, and acupuncture.
The patient, guided by the physician to the extent that the patient wishes, then chooses a treatment option e. Any relief the patient receives from acupuncture is attributed either to its physiological properties or to placebo effects.
