Response to commentaries on sharing online clinical notes with patients: implications for nocebo effects and health equity

Journal of Medical Ethics 49 (1):32-33 (2022)
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Abstract

I am grateful for the variety of feedback. Three themes struck me: first, commentators recognised the value of open notes but underlined the importance of exploring unintended consequences of the innovation particularly for already disadvantaged populations; second, they suggested nocebo effects might arise via additional routes not identified in my paper; third, they signalled the need for further empirical and ethical exploration of nocebo effects. Exploring all three issues and offering a commentary that was equal parts intriguing and perturbing, Chang and Torous proposed nocebo effects and other harms might be ubiquitous in the digital health space. 1 For example, they hypothesised that the preoccupation with checking health tracking data including adverse readings or outcomes available via downloadable apps and wearable devices might induce nocebo effects. This supposition is worthy of further scrutiny. Chang and Torous also highlighted the lack of research into potentially disparate effects of digital...

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