The ethics of positive thinking in healthcare
In continuation with the New Thought movement that arose in the United States in the 19th Century, there is now a massive self-help industry that markets books and seminars. This industry has also extended to healthcare in the form of positive thinking, i.e., the idea that happy thoughts are essential for health. While some of these claims may seem reasonable and commonsensical, they are not free of problems. This article posits that positive thinking has some ethical underpinnings. Extreme positive thinking may promote alternative forms of medicine that ultimately substitute effective treatment, and this is unethical. The emphasis on positive thinking for cancer patients may be too burdensome for them. Likewise, unrestricted positive thinking is not necessarily good for mental health. After considering the ethics of positive thinking, this article proposes a more realistic approach.
Schopenhauer A. On the vanity of existence. [cited 2019 December]; Available from: https://en.wikisource.org/wiki/On_the_Vanity_of_Existence
Benatar D. Better to Never Have Been: The Harm of Coming into Existence. UK: Oxford University Press; 2008, p. 1.
Leibniz GW. Theodicy. USA: Echo Library; 2008.
Haller JS. The History of New Thought: From Mind Cure to Positive Thinking and Prosperity Gospel. USA: Swedenborg Foundation Publishers; 2012.
Collins G. Cosmopsychology: The Psychology of Humans as Spiritual Beings. USA: Xlibris; 2009, p. 471.
Gray J. Voltaire: The Great Philosophers. USA: Routledge. 1999.
Vyse SA. Believing in Magic: The Psychology of Superstition. UK: Oxford University Press; 2000.
Jackson M. The Age of Stress: Science and the Search for Stability. UK: Oxford University Press; 2013.
Daruna JH. Introduction to Psychoneuroimmunology, 2nd ed. USA: Academic Press; 2012.
Shapiro A, Shapiro E. The Powerful Placebo: From Ancient Priest to Modern Physician. USA: John Hopkins University Press; 2000.
Hall H. Placebo, are you there? [cited 2019 December]; Available from: https://sciencebasedmedicine.org/placebo-are-you-there/
Lipson P. Asthma, placebo, and how not to kill your patients. [cited 2019 December]; Available from: https://sciencebasedmedicine.org/asthma-placebo-and-how-not-to-kill-your-patients/
Blease C, Colloca L, Kaptchuk T. Are open-label placebos ethical? informed consent and ethical equivocations. Bioethics. 2016; 30 (6): 407-14.
Goodman S. 9 Steps for Reversing or Preventing Cancer and Other Diseases. USA (Newburyport): Weiser Publication; 2004.
Chopra D. Quantum Healing. USA (New York): Bantam; 1990.
Simonton OC, Creighton J, Simonton SM. Getting well again. USA (New York): Bantam; 1992.
Giltay EJ, Geleijnse JM, Zitman FG, Hoekstra T, Schouten EG. Dispositional optimism and all-cause and cardiovascular mortality in a prospective cohort of elderly Dutch men and women. Arch Gen Psychiatry. 2004; 61(11): 1126-35.
Lamers SM, Bolier L, Westerhof GJ, Smit F, Bohlmeijer ET. The impact of emotional well-being on long-term recovery and survival in physical illness: a meta-analysis. J Behav Med.2012; 35(5): 538-47.
Rasmussen H, Scheier M & Greenhouse J. Optimism and psysical health: a meta-analytic review. Ann Behav Med.2009; 37(3): 239-56.
Ong AD, Mroczek DK, Riffin C. The health significance of positive emotions in adulthood and later life. Soc Personal Psychol Compass. 2011; 5(8): 538-51.
Eskelinen M, Ollonen P. Assessment of 'cancer-prone personality' characteristics in healthy study subjects and in patients with breast disease and breast cancer using the commitment questionnaire: a prospective case-control study in Finland. Anticancer Res. .2011; 31(11): 4013-7.
Beyerstein BL, Sampson WI, Stojanovic Z, Handel J. Can mind conquer cancer? In; S. Della Sala, ed. Tall Tales about the Mind and Brain: Separating Fact from Fiction. UK (Oxford): Oxford University Press; 2007.
Frankl VE. Man’s Search for Meaning. USA (Boston): Beacon Press. 2006.
Ehrenreich B. Bright Sided: How the Relentless Promotion of Positive Thinking Has Undermined America. USA (New York): Metropolitan Press; 2009.
Coyne JC, Stefanek M, Palmer SC. Psychotherapy and Survival in Cancer: The Conflict between Hope and Evidence. Psychol Bull. 2007; 133(3): 367-94.
Molnar A. Cancer survival is not influenced by a patient’s emotional status. [cited 2019 December]; Available from: http://www.bio-medicine.org/medicine-news-1/Cancer-survival-is-not-influenced-by-a-patients-emotional-status-4214-1/
Tennet H, Affleck G. Benefit finding and benefit reminding. In: Snyder CR, Lopez SJ, eds. Handbook of Positive Psychology. UK: Oxford University Press; 2003.
The new reference should be:
King S. Pink Ribbons Inc.: Breast cancer activism and the politics of philanthropy. International Journal of Qualitative Studies in Education. 2004; 17(4), 473-92.
Segal JZ. Breast cancer narratives as public rhetoric: genre itself and the maintenance of ignorance. Linguistics and The Human Sciences. 2007; 3(1).
Punjani NS, Bhanji SM, Mehgani ST, Shah M. Health care Ethics- Am I Dying. International Journal of Endorsing Health Science Research. 2014; 2(1): 28-30.
Kurtz P. The Transcendental Temptation. USA (New York): Prometheus; 2013.
Novella S. The Skeptics' Guide to the Universe: How to Know What's Really Real in a World Increasingly Full of Fake. USA (New York): Grand Central Publishing; 2018.
Gravois J. Think negative! [cited 2019 December]; Available from: https://slate.com/culture/2007/05/dear-oprah-please-stop-promoting-the-secret.html
Andrade G. Ryke Geerd Hammer and the dangers of positive thinking. [cited 2019 December]; Available from: https://www.prindlepost.org/2017/07/ryke-geerd-hamer-dangers-positive-thinking/
Lerner M. The Belief in a Just World: A Fundamental Delusion. USA (New York): Springer; 1980.
Chapple A, Ziebland S, McPherson A. Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. BMJ. 2004; 328(7454): 1470.
Hidaka B. Depression as a disease of modernity: explanations for increasing prevalence. J Affect Disord. 2012; 140(3): 205-14.
Salerno S. Sham: How the Self Help Movement Made America Helpless. USA (New York): Crown Forum; 2005.
George CVR. God's Salesman: Norman Vincent Peale and the Power of Positive Thinking, 2nd ed. USA: Oxford University Press; 2019.
Gittomer J. How to get Sh*t Done: The Ultimate Guide to Productivity, Procrastination, and Profitability. USA (New York): Wiley; 2019.
Seligman MP. Flourish: A New Understanding of Happiness and Well-being. USA (New York): Atria Books; 2012.
Proyer RT, Gander F, Wellenzhon S, Ruch W. The authentic happiness inventory revisited: addressing its psychometric properties, validity, and role in intervention studies. Journal of Well-being Assessment. 2017; 1(1-3): 77-96.
Power M. Understanding Happiness: A Critical Review of Positive Psychology. USA (New York): Routledge; 2015.
Pies R. The bereavement exclusion and DSM-5: an update and commentary. Innov Clin Neurosci. 2014; 11(7-8): 19-22.
Norem JK, Cantor N. Defensive pessimism: harnessing anxiety as motivation. J Pers Soc Psychol. 1986; 51(6): 1208-17.
Wood JV, Perunovic WQ, Lee JW. Positive self-statements: power for some, peril for others. Psychol Sci. 2009; 20(7): 860-6.
Moran A. Sport and Exercise Psychology: A Critical Introduction. USA (New York): Routledge; 2004, p. 86.
Forgas JP. Don’t worry, be sad! on the cognitive, motivational, and interpersonal benefits of negative mood. Current Directions in Psychological Science. 2013; 22(3): 225-32.
Oishi S, Diener E, Lucas RE. The optimum level of well-being: can people be too happy? Perspectives on Psychological Science. 2007; 2(4): 346-60.
Von Helversen B, Wilke A, Johnson T, Klapp B. Performance benefits of depression: sequential decision making in a healthy sample and a clinically depressed sample. J Abnorm Psychol. 2011; 120(4): 962-8.
Kahneman D. Thinking, Fast and Slow. USA (New York): Farrar, Strauss and Giroux; 2011.
Saposnik G, Redelmeier D, Ruff C, Tobbler P. Cognitive biases associated with medical decisions: a systematic review. BMC Medical Informatics and Decision Making. 2016; 16: 138
Levi H, DeLeire T. What do people buy when they don't buy health insurance and what does that say about why they are uninsured? Inquiry. 2008-2009; 45(4): 365-79.
Sparks P, Shepherd R, Wieringa N, Zimmermanns N. Perceived behavioural control, unrealistic optimism and dietary change: an exploratory study. Appetite.1995; 24(3): 243-55.
Caprara GV, Steca P, Gerbino M, Paciello M, Vecchio GM. Looking for adolescents' well-being: Self-efficacy beliefs as determinants of positive thinking and happiness. Epidemiol Psichiatr Soc. 2006; 15(1): 30-43.
Brickman B, Coates D, Janoff-Bulman R. Lottery winners and accident victims: is happiness relative? J Pers Soc Psychol. 1978; 36(8): 917-27.
Eker T. Secrets of the Millionaire Mind: Mastering the Inner Game of Wealth. USA (New York): Harper Business; 2005.
Clark PA. The ethics of alternative medicine therapies. J Public Health Policy.2000; 21(4): 447-70.
Makridakis S, Moleskis A. The costs and benefits of positive illusions. Front Psychol. 2015; 6: 859.
Dietz A. Explaining the Paradox of Hedonism. Australasian Journal of Philosophy. 2019; 97(3): 497-510.
Soderkvist S, Ohlen K, Dimberg U. How the experience of emotion is modulated by facial feedback. Journal of Nonverbal Behavior. 2018; 42(1): 129-151.
Reeves R. John Stuart Mill: Victorian Firebrand. UK (London): Atlantic Books; 2008.
Williamson M. The Law of Divine Compensation: On Work, Money, and Miracles. USA (New York): Harper One; 2012.