Placebo effect

Some interesting ethical questions are being raised about doctors prescribing placebos to patients, following a study was released last week in the British Medical Journal on the issue.

Like, what right do patients have to know details of what they are being prescribed, and what impact do placebos have on general public health?

University of Pennsylvania ethicist Arthur Caplan warns that the so-called placebo effect -- people getting better simply because they believe a medicine will work -- could be undermined by doctors prescribing them so much. The doctor-patient relationship could also be hurt.

"The real issue is whether widespread analysis of the practice of using placebos will undermine the value of placebo...and whether patients in any way begin to distrust their doctors suspecting them of resorting to placebos and thus lying to them."

The problem is that telling people they are getting a placebo would also likely undermine the effect, so  honesty suffers along with a patient's right to know.

The study found that few of the placebos prescribed are actually "sugar pills."

Many, in fact, are antibiotics that doctors know won't work in all cases -- such as for viral infections. But by prescribing them when they are not needed, doctors may be contributing to the over-presence of anti-biotics in society -- which many blame for the emergence of so-called superbugs resistant to anti-biotics. Caplan would like to see more discussion about what constitutes a placebo.

"Too many doctors give antibiotics as a kind of placebo, especially to kids of demanding or helicoptering parents -- knowing they don't work against viral diseases (and) thereby creating real public health problems!"

Comments

[Susan Wenger]

Thanks so much for posting about this. With awareness of those "superbugs" rising, it's hard for me to believe that doctors knowingly prescribe antibiotics for non-bacterial infections.

Doctors who prescribe other kinds of placebos to people with chronic diseases can also do real harm, and not just to the doctor-patient relationship. I've posted more about this here: http://cinderbridge.blogspot.com/2008/10/imaginary-treatments-for-real-diseases.html