Many American doctors give their patients a placebo, an innocuous drug in the guise of medical treatment, intended to make them feel better. It is called the ‘placebo effect.A National Survey was sent to 1,200 intern and rheumatologists, of which 679 responded. The report published in the British Medical Journal revealed that 46-58% of the US physicians admitted use of placebos as a feel good factor. Only 5% disclosed to their patients that they are doing so.Only 3% of the doctors reported prescribing sugar pills, nearly 41% used pain killers as placebos, 38% used vitamins, 13% antibiotics and 13% used sedatives.
Almost two thirds believed the practice to be ethically permissible. Dr Farr. A Currin, assistant professor of medicine at the University of Chicago, openly acknowledged that placebo treatment is common in medical practice. “The placebo effect is a real effect. People do feel better. To the extent that if it can be mobilized in a way that is restful and not actively deceiving patients, I think it is acceptable.”
The general opinion that if it does not harm, there is no toxicity and does some good, placebo treatment may be recommended to patients as ‘a medicine not used typically for your condition but might benefit you.Andrew Leuchter, assistant dean of school of medicine at the University of California, Los Angles, believes that he best way to explain a placebo treatment is to say “there is no reasonable medical evidence that this pill is effective for your condition, but some people who take this pill say it makes them feel better.”
Franklin G Miller, one of the authors of the study, troubled by the results, felt that the use of placebo without the patient’s knowledge may undermine trust and compromise the patient physician relationship. Dr William Schreiber, an intern at Louisville, disagreed with the findings of the study. When questioned about treatment of psychosomatic problems like fibromyalia, he relented. In such cases difficult patients are administered large doses of Aleve. Never the less he was assertive in declaring that antibiotics and sedatives cannot be called placebos.
When doctors run out of treatments for untreatable and chronic conditions they are willing to virtually try anything, to make the patient feel better, even if happens to be a psychological measure. Nearly 30-40% patients prone to depression, hypertension and pain, have triggered positive results when placebos are used making it a ‘benevolent deception.’
Though doctors have anything but the best interest of the patient in mind, Dr Howard Brody, director of the Institute for Medical Humanities of the University of Texas, feels that random use of placebos should be curtailed because it depicts the message that “when something is the matter with you, you will not get better, unless you swallow pills.”
The arguments about the ethics of placebo treatment are endless. Placebos harness the power of the mind to help heal the ailing body. It is the unproven theory driven by the benefits of psychological expectation as against physiological effects of a treatment. The ethics surrounding are still up for a challenge. A placebo given simply to mollify a difficult patient is incorrect, as it serves the convenience of the physician more than promoting the welfare of the patient.