The Physician's Responsibility for the Nostrum Evil.

Cabot, Richard C.

doi:10.1001/jama.1906.25210130006001b

Cited by 16 publications

(6 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…At the beginning of this century, Richard Cabot blamed frequent use of placebos for the “nostrum evil.” Physicians prescribed placebos because the patients felt that if they did not have some sort of pill or potion, they wouldn't get better. But patients were not born believing that; they learned it, in part, from the prescribing behavior of physicians 3 . Similarly, today's physician might reason: patients and families sometimes feel abandoned and not really “cared for” if they are made do‐not‐resuscitate; and by agreeing to “code” patients who cannot really benefit, we perpetuate that unrealistic expectation among patients and families.…”

Section: What Violates Integrity?mentioning

confidence: 99%

See 1 more Smart Citation

The Physician's Role in Determining Futility

Brody¹

1994

J American Geriatrics Society

View full text Add to dashboard Cite

Section: What Violates Integrity?mentioning

confidence: 99%

“…Futility judgments contain an irreducible value component. 3. The sorts of values that go into futility judgments are not within the exclusive expertise of physicians.…”

mentioning

confidence: 99%

The Physician's Role in Determining Futility

Brody¹

1994

J American Geriatrics Society

View full text Add to dashboard Cite

“…In the first place, the negative connotation of placebo is derived from the chemotherapy paradigm. The use of placebo groups to search for specific, physiochemical causes and cures has been entwined with a history of political antagonism toward herbalists, quacks, and charlatans who proffered cures that were not founded upon specific, physiochemical principles (Berg, 1977;Brody, 1980, Burrow, 1977Cabot, 1906;Griggs, 1981;Houston, 1938;Roueche, 1960;Shapiro, 1960Shapiro, , 1964Shapiro, , 1968Young, 1961). The professional question for organized medicine was not whether those treatments were efficacious, but whether they involved physiochemical causes.…”

Section: Psychotherapy Efficacymentioning

confidence: 99%

Psychotherapy: The powerful placebo.

Wilkins¹

1984

Journal of Consulting and Clinical Psychology

View full text Add to dashboard Cite

Research designs in which psychotherapy treatments are compared to placebo conditions were derived from analogies with chemotherapy research. However, chemotherapy and psychotherapy research efforts are complementary rather than analogous. Chemotherapy placebos are delivered to eliminate the psychological variables that psychotherapy researchers attempt to elucidate. Psychotherapy treatments are actually analogous to chemotherapy placebos, rather than to chemotherapy treatments. It is gratuitous to continue to view chemotherapy artifacts, such as client outcome expectancies, as de facto artifacts in psychotherapy research. The elimination of placebo groups in psychotherapy research is recommended. The negative connotation of psychotherapy as a placebo is discussed.

show abstract

“…Discussions of the placebo effect in clinical practice have long contended with themes of deception, paternalism, and violations of autonomy. In 1907, Richard Cabot (2) argued that “every placebo is a lie, and in the long run the lie is found out”. Arnold et al (3) described the state of play more recently: “Conscious, deliberate, or incidental/unwitting utilization of the placebo effect is characterized as deceptive, unethical, unscientific, and unprofessional.” Similarly, Kolber (4) reports on how placebo treatments are referred to by some as medicine’s “dirty little secrets.” In line with these associations, most bioethical discussions of the placebo effect revolve around the moral permissibility of using deception within the clinical encounter if it is likely to benefit the patient 1 .…”

Section: Introduction: “The Lie That Heals”mentioning

confidence: 99%

Placebos as a Source of Agency: Evidence and Implications

Friesen

2019

Front. Psychiatry

View full text Add to dashboard Cite

Bioethical discussions surrounding the use of placebos in clinical practice have long revolved around the moral permissibility of deceiving a patient if it is likely to benefit them. While these discussions have been insightful and productive, they reinforce the notion that placebo effects can only be induced through deception. This paper challenges this notion, looking beyond the paradigmatic clinical encounter involving deceptive placebos and towards many other routes that bring about placebo effects. After briefly describing the bioethical terrain surrounding the deceptive use of placebos in clinical practice, section 1 offers an examination of the various mechanisms known to contribute to placebo effects: classical conditioning, expectations, affective pathways, open-label placebo treatments, and additional factors that do not fall easily into a single category. The following section explores how each of these routes can be harnessed to bring about clinical benefits without the use of deception. This provides grounding for reconceiving of the placebo effect as a clinical tool that is not always in conflict with patient autonomy and can even be seen as a source of agency. In the final section, implications of the shift away from seeing placebos as necessarily deceptive are discussed. These include the necessity of looking beyond the clinical encounter and mainstream medicine as the primary sites of placebo responses, how important acknowledging the limits of placebo effects will be when we do so, as well as the difficulties of disentangling agency, responsibility, and blame within medicine.

show abstract

The Physician's Responsibility for the Nostrum Evil.

Cited by 16 publications

References 1 publication

The Physician's Role in Determining Futility

The Physician's Role in Determining Futility

Psychotherapy: The powerful placebo.

Placebos as a Source of Agency: Evidence and Implications

Contact Info

Product

Resources

About