Council on Palliative Care Issues. American Osteopathic Association's Position Against Use of Placebos for Pain Management in End-of-Life Care. J Am Osteopath Assoc 2007;107(suppl_4):ES35-ES38. doi: .
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A number of organizations have advised against the use of placebo substitution, including the American Pain Society, Agency for Healthcare Policy and Research, World Health Organization, Healthcare Facilities Accreditation Program, Joint Commission on Accreditation of Healthcare Organizations, Education for Physicians on End-of-Life Care Project (cosponsored by the American Medical Association and The Robert Wood Johnson Foundation), American Nursing Association, and the American Society of Pain Management Nurses.
This white paper describes the literature and rationale in support of the American Osteopathic Association's (AOA's) position on the controversial subject of the use of placebos for pain management in terminally ill patients.
The following policy statement was adopted by the AOA's House of Delegates in 2005. This statement was drafted by the association's Council on Palliative Care Issues, which at that time was called the End-of-Life Care Committee.
This statement has been modified to adhere to the house style of JAOA—The Journal of the American Osteopathic Association.
A positive placebo response simply speaks to the strength of an individual's central control processes (i.e., mind) to recruit their descending inhibitory system to block pain. The osteopathically trained physician knows that pain relief occurs both in the mind and in the body.
... a primary, chronic, neurobiologic disease, with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.
...the American Bar Association urges federal, state, and territorial governments to support fully the right of individuals suffering from pain to be informed of, choose, and receive effective pain and symptom evaluation, management, and ongoing monitoring as part of basic medical care, even if such pain and symptom management may result in analgesic tolerance, physical dependence, or as an unintended consequence shortens the individual's life.
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