Half of U.S. doctors say they use placebo treatments.
About half of American doctors in a new survey say they regularly give patients placebo treatments – usually drugs or vitamins that won't really help their condition.
And many of these doctors are not honest with their patients about what they are doing, the survey found.
That contradicts advice from the American Medical Association, which recommends doctors use treatments with the full knowledge of their patients.
“It's a disturbing finding,” said Franklin G. Miller, director of the research ethics program at the U.S. National Institutes Health and one of the study authors. “There is an element of deception here which is contrary to the principle of informed consent.”
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Most doctors used actual medicines as a placebo treatment: 41 per cent used painkillers, 38 per cent used vitamins, 13 per cent used antibiotics, 13 per cent used sedatives, 3 per cent used saline injections, and 2 per cent used sugar pills.
Placebo from the Latin I will please. A doctor pleases the patient by prescribing a placebo, a treatment that the doctor knows is ineffectual but the patient is led to believe is effective.
A placebo won't work if the patient knows it's a placebo. So what to do about the ethical challenges?
Well to start, doctors shouldn't be prescribing antibiotics or sedatives.
Dr. Ezekiel J. Emanuel, one of the study’s authors, said doctors should not prescribe antibiotics or sedatives as placebos, given those drugs’ risks. Use of less active placebos is understandable, he said, since risks are low.
“Everyone comes out happy: the doctor is happy, the patient is happy,” said Dr. Emanuel, chairman of the bioethics department at the health institutes. “But ethical challenges remain.”
Mindful Hack writes about placebos and nocebos.
Doctors use the placebo effect automatically in their work. For example, they behave confidently and reassuringly even when completely stumped by the patient's symptoms or faced suddenly with a life-threatening disorder. They are right to behave this way. A doctor's anxiety would trigger the placebo effect's evil twin, the nocebo effect. "Nocebo" means "I will harm," and nocebos really do harm. Patients may be ill for longer periods and suffer worse symptoms if nocebo effects convince them that they are doomed.
Some consider the placebo effect a mystery. In March 2005, British science magazine New Scientist listed thirteen "Things That Don't Make Sense", and the placebo effect was number one on their list. Of course, the placebo effect doesn't "make sense" if you assume, as they do, that the mind either does not exist or is powerless. The traditional Christian view is that the mind is grounded in the brain so long as we live in this world. Therefore, what the patient's mind perceives expresses itself in the brain and body. Both the placebo and nocebo effects are strong support for the traditional view.