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Friday 21st October 2016

Should doctors give patients placebos?

31st October 2008

The Economist examines the placebo effect.


Doctors have prescribed placebos for centuries, though often without telling patients the pills contain nothing proven to cure their ailment.

Some consider this a virtuous lie, others that it is unethical outside of a clinical trial setting.

In 2006 the American Medical Association warned physicians they may use a placebo only if the patient agrees to its use.

A recent survey of 1,200 general practitioners and rheumatologists attempted to see whether doctors were observing the ruling.

Some 679 physicians replied with more than half saying that they prescribed placebo treatments at times and believed the practice ethical.

Trials have shown that placebos do actually work. How they work is something that is also starting to be understood.

It seems the key to the placebo effect lies with the patient and their "positive expectation of a reward", according to Nico Diederich, a neuroscientist at Centre Hospitalier de Luxembourg, with researchers pointing to the "hidden dosing" technique as demonstrating the power of the placebo.

However, it is also recognised that "overworked doctors use them to deal with troublesome patients".

Even this may be considered legitimate in some cases: where a patient’s suffering is due to behavioural or psychological factors, rather than physiological ones.

But a placebo can also be a way of getting a "whingeing patient" out of the door quickly.

The controversy over placebos is set to continue. In the meantime, doctors are likely to "continue to experiment with this potentially powerful tool while they wait for science to explain why it works".


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