Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study
Muhammad M Hammami,1,2 Safa Hammami,3 Reem Aboushaar,4 Ahmed S Aljomah1 1Clinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 2Alfaisal University College of Medicine, Riyadh, Saudi Arabia; 3St. Mary Medical Center, San Francisc...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Dove Medical Press
2019-09-01
|
Series: | Patient Preference and Adherence |
Subjects: | |
Online Access: | https://www.dovepress.com/lay-peoples-ethical-attitudes-to-placebo-treatment-a-q-methodology-stu-peer-reviewed-article-PPA |
id |
doaj-a42d201ebc564ea8812a7685e8c9d6bb |
---|---|
record_format |
Article |
spelling |
doaj-a42d201ebc564ea8812a7685e8c9d6bb2020-11-25T02:08:39ZengDove Medical PressPatient Preference and Adherence1177-889X2019-09-01Volume 131599161748844Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology StudyHammami MMHammami SAboushaar RAljomah ASMuhammad M Hammami,1,2 Safa Hammami,3 Reem Aboushaar,4 Ahmed S Aljomah1 1Clinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 2Alfaisal University College of Medicine, Riyadh, Saudi Arabia; 3St. Mary Medical Center, San Francisco, CA, USA; 4MS IV, Florida Atlantic University, Boca Raton, FL, USACorrespondence: Muhammad M HammamiClinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Centre, P O Box # 3354 (MBC 03), Riyadh 11211, Saudi ArabiaTel +966-1-442-4527Fax +966-1-442-7894Email Muhammad@kfshrc.edu.saBackground: Placebo-treatment acceptability is debated among ethicists, mostly due to conflict between respect-to-autonomy and beneficence principles. It is not clear how lay people balance these and other ethical principles.Methods: One hundred and eighty-seven respondents rank-ordered 42 opinion statements covering various ethical aspects of placebo-treatment, according to a 9-category symmetrical distribution. We analyzed statements’ scores using averaging-analysis and by-person factor analysis (Q-methodology).Results: Respondents’ mean (SD) age was 34.6 (10.6) years, 54% were women, 40% healthcare-related, 68% Muslims (31% Christians), and 39% received general education in Saudi Arabia (24% in the Philippines). On averaging-analysis, the most-agreeable statements were “Acceptable if benefit to patient large” and “Acceptable with physician intent to benefit patient”. The most-disagreeable statements were “Acceptable with physician self-benefit intent” and “Acceptable with large harm to other patients”. Muslims gave a higher rank to “Giving no description is acceptable”, “Acceptable with small benefit to patient”, and “Acceptable with physician intent to benefit patient” and a lower rank to “Acceptable to describe as inactive drug”, “Acceptable with physician intent to please patient caring relative”, and “Acceptable with moderate harm to other patients” (p<0.01). Q-methodology detected several ethical attitude models that were mostly multi-principled and consequentialism-dominated. The majority of Christian and Philippines-educated women loaded on a “relatively family and deception-concerned” model, whereas the majority of Muslim and Saudi Arabia-educated women loaded on a “relatively common-good-concerned” model. The majority of Christian and healthcare men loaded on a “relatively deception-concerned” model, whereas the majority of Muslim and non-healthcare men loaded on a “relatively motives-concerned” model. Of nine intent-related statements, ≥2 received extreme rank on averaging-analysis and in 100% of women and men models.Conclusion: 1) On averaging-analysis, patient’s beneficence (consequentialism) followed by physician’s intent (virtue ethics) were more important than deception (respect-to-autonomy). 2) Q-methodology identified several ethical attitude models that were mostly multi-principled and associated with respondents’ demographics.Keywords: lay people attitude, placebo treatment, virtue, common good, principlism, Q-methodologyhttps://www.dovepress.com/lay-peoples-ethical-attitudes-to-placebo-treatment-a-q-methodology-stu-peer-reviewed-article-PPALay people attitudePlacebo treatmentVirtueCommon goodPrinciplismQ-methodology. |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hammami MM Hammami S Aboushaar R Aljomah AS |
spellingShingle |
Hammami MM Hammami S Aboushaar R Aljomah AS Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study Patient Preference and Adherence Lay people attitude Placebo treatment Virtue Common good Principlism Q-methodology. |
author_facet |
Hammami MM Hammami S Aboushaar R Aljomah AS |
author_sort |
Hammami MM |
title |
Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study |
title_short |
Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study |
title_full |
Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study |
title_fullStr |
Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study |
title_full_unstemmed |
Lay People’s Ethical Attitudes To Placebo Treatment: A Q-Methodology Study |
title_sort |
lay people’s ethical attitudes to placebo treatment: a q-methodology study |
publisher |
Dove Medical Press |
series |
Patient Preference and Adherence |
issn |
1177-889X |
publishDate |
2019-09-01 |
description |
Muhammad M Hammami,1,2 Safa Hammami,3 Reem Aboushaar,4 Ahmed S Aljomah1 1Clinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; 2Alfaisal University College of Medicine, Riyadh, Saudi Arabia; 3St. Mary Medical Center, San Francisco, CA, USA; 4MS IV, Florida Atlantic University, Boca Raton, FL, USACorrespondence: Muhammad M HammamiClinical Studies and Empirical Ethics Department, King Faisal Specialist Hospital and Research Centre, P O Box # 3354 (MBC 03), Riyadh 11211, Saudi ArabiaTel +966-1-442-4527Fax +966-1-442-7894Email Muhammad@kfshrc.edu.saBackground: Placebo-treatment acceptability is debated among ethicists, mostly due to conflict between respect-to-autonomy and beneficence principles. It is not clear how lay people balance these and other ethical principles.Methods: One hundred and eighty-seven respondents rank-ordered 42 opinion statements covering various ethical aspects of placebo-treatment, according to a 9-category symmetrical distribution. We analyzed statements’ scores using averaging-analysis and by-person factor analysis (Q-methodology).Results: Respondents’ mean (SD) age was 34.6 (10.6) years, 54% were women, 40% healthcare-related, 68% Muslims (31% Christians), and 39% received general education in Saudi Arabia (24% in the Philippines). On averaging-analysis, the most-agreeable statements were “Acceptable if benefit to patient large” and “Acceptable with physician intent to benefit patient”. The most-disagreeable statements were “Acceptable with physician self-benefit intent” and “Acceptable with large harm to other patients”. Muslims gave a higher rank to “Giving no description is acceptable”, “Acceptable with small benefit to patient”, and “Acceptable with physician intent to benefit patient” and a lower rank to “Acceptable to describe as inactive drug”, “Acceptable with physician intent to please patient caring relative”, and “Acceptable with moderate harm to other patients” (p<0.01). Q-methodology detected several ethical attitude models that were mostly multi-principled and consequentialism-dominated. The majority of Christian and Philippines-educated women loaded on a “relatively family and deception-concerned” model, whereas the majority of Muslim and Saudi Arabia-educated women loaded on a “relatively common-good-concerned” model. The majority of Christian and healthcare men loaded on a “relatively deception-concerned” model, whereas the majority of Muslim and non-healthcare men loaded on a “relatively motives-concerned” model. Of nine intent-related statements, ≥2 received extreme rank on averaging-analysis and in 100% of women and men models.Conclusion: 1) On averaging-analysis, patient’s beneficence (consequentialism) followed by physician’s intent (virtue ethics) were more important than deception (respect-to-autonomy). 2) Q-methodology identified several ethical attitude models that were mostly multi-principled and associated with respondents’ demographics.Keywords: lay people attitude, placebo treatment, virtue, common good, principlism, Q-methodology |
topic |
Lay people attitude Placebo treatment Virtue Common good Principlism Q-methodology. |
url |
https://www.dovepress.com/lay-peoples-ethical-attitudes-to-placebo-treatment-a-q-methodology-stu-peer-reviewed-article-PPA |
work_keys_str_mv |
AT hammamimm laypeoplersquosethicalattitudestoplacebotreatmentaqmethodologystudy AT hammamis laypeoplersquosethicalattitudestoplacebotreatmentaqmethodologystudy AT aboushaarr laypeoplersquosethicalattitudestoplacebotreatmentaqmethodologystudy AT aljomahas laypeoplersquosethicalattitudestoplacebotreatmentaqmethodologystudy |
_version_ |
1724926356395917312 |