Telling the Truth about Pain: Informed Consent and the Role of Expectation in Pain Intensity.
Dr. Nada Gligorov, Associate Professor, The Bioethics Program, Icahn School of Medicine at Mount Sinai
Wednesday, 24 April 2019, 11am to 12.30pm
Ethox and the Wellcome Centre for Ethics and Humanities are based at the Big Data Institute, University of Oxford, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Oxford OX3 7FZ. The talk will be held in seminar room 0.
Health care providers are expected both to relieve pain and to provide anticipatory guidance regarding how much a procedure is going to hurt. Fulfilling those expectations is complicated by the cognitive modulation of pain perception. Warning people to expect pain or setting expectations for pain relief not only influences their subjective experience, but it also alters how nociceptive stimuli are processed throughout the sensory and discriminative pathways in the brain. In light of this, I reconsider the characterization of placebo analgesia as pharmacologically inert and the use of it as deceptive. I show that placebo analgesia exploits the same physical mechanisms as proven analgesics and argue that it should be utilized to relieve pain. Additionally, I describe factors to help identify situations in which clinicians have the obligation to disclose the potential for pain coupled with ways of mitigating the risk of high-intensity pain by setting positive expectations.