Effect nocebo, and the contextualized informed consent: some thoughts on its application in ophthalmology

Abstract

The respect to the principle of autonomy and informed consent obligates physicians to explain patients the possible side effects when prescribing medications. This disclosure may itself induce adverse effects or negative placebo. This fact contradicts the principle of non-maleficence in vulnerable patients as in ophthalmological disease. There is some tension between information to the patient that takes into account possible side effects. The Informed consent to patient for off label drugs used for example in ophthalmology is a new contextualized legal ethical question. This article has for objective to alert to the doctor for the effect risk nocebo. The doctor has the duty to explain and the patient the right to be explained about the advantages, disadvantages, risks and benefits of any medication. The contextualized informed consent suggests a pragmatic approach for providers to minimize nocebo responses while still maintaining patient autonomy through, by means of the form as it informs.