The Ethics of Giving Placebos

Considerations and Caveats for the Use of Placebo Responses in Clinical Care: Minding the Matter of Mechanisms–and Morality– in Medical Treatment

“…As consistent with Bok (1974), I also claim that using placebo in the clinical setting may be acceptable if 1) there is an established clinician-patient relationship; 2) a diagnosis supports the viability of such intervention and does not mandate other treatment(s); 3) the patient requires and requests some form of intervention; 4) it does not interfere with (other) diagnostic and therapeutic interventions, 5) it does not incur costs beyond the minimal fees required for the attendance of the treating clinician, and 6) other treatments have not been effective. By definition, placebo responses are those that evoke a positive effect in the patient.…”

“…Additionally, while placebo responses and effect(s) may be viewed as valid means to mitigate the signs and symptoms of certain types of disorders, I believe, pro philosopher Sisela Bok, that achieving these means by blatantly lying incurs ethical harms through: 1) intentional deception, 2) undermining the veracity that establishes and maintains trust within the physicianpatient relationship, 3) denying patients information necessary for valid informed consent, and 4) impugning patients' autonomy, in this sense, the negative right to refuse particular treatments (Bok, 1974;see also: Gillon, 1985;and Bloche, 2000). This impels consideration of if and how placebo responses might be ethically achieved and used in clinical practice.…”

“…Communicating this uncertainty to patients with a sense of optimism allows for veracity and intellectual honesty, while still fostering trust and hope (Giordano and Boswell, 2005;Geers et al, 2005;Spiro, 1986). Giordano Ethico-legal questions also center upon the cost of interventions that are used to evoke placebo responses (Bok, 1974). Namely, should these be billable?…”

Drug utilization pattern in four major wards of a tertiary hospital in eastern Nepal

“…placebo therapy has been criticized as deception. 21 Most of the drugs (32.72%) were prescribed as intravenous injections. In a recent study, 62% patients received drugs intravenously.…”

Expectations of drug effects based on colour and size of tablets

“…Placebo gyógyszerek és kezelések szándékos és tudatos használata etikai okok (elsôsorban a megtévesztés) miatt manapság nem engedélyezett (Bok 1974(Bok , 2002Brody 1982;Köteles és mtsai 2007). Ezek az etikai aggályok elsôsorban a betegek (félre)informálása tekintetében vetôdhetnek fel, miközben -mint láttuk -a nem-specifikus hatások számos más úton-módon is kiválthatók.…”