A Placebo is defined as any medication or procedure that the physician believes has no specific pharmacological activity against the condition being treated. A Placebo just looks like a regular treatment or medicine, but it’s not. The person getting a placebo does not know for sure that the treatment is not real. A placebo often take the form of sugar pills, saline injections, miniscule doses of drugs, or sham procedures designed to be void of any known therapeutic value. They may be used in clinical practice to determine a diagnosis or appropriate treatment in the face of clinical uncertainty. The use of placebo in clinical practice has received much more attention since past few years. A national Survey of primary care practitioners has found that nearly all doctors have given their patients placebos. The study shows placebo use is widespread in the UK, and doctors clearly believe placebos can help patients. Researchers say 97 percent admitted giving ‘impure’ placebos, those which have medical value but are unproven in the illness they are given for. Meanwhile, 12 percent had used ‘pure’ placebos, such as sugar pills. Of the doctors surveyed, 66 percent said pure placebos were ethically acceptable in certain circumstances, while 33 percent said they were never acceptable. Impure placebos were considered acceptable by 84 percent of doctors. More than 90 percent objected to using either type if it endangered patient-doctor trust, but nearly 20 percent said they might use placebos even if it involved deception. This study does not explicitly discuss or prohibit the use of placebos in the treatment of patients, other than mentioning placebos in a footnote of their research guidance. However, the results show that doctors are generally using placebos in good faith to help patients.
Now that we know placebos are being used on people across a range of maladies, the task ahead is to figure out how to optimize the placebo effect and how to customize placebos to perform better for individual cases. In clinical setting, the use of a placebo without the patient’s knowledge may undermine trust, compromise the patient-physician relationship and result in medical harm to the patient. Physicians administer placebo because placebo might relieve the symptoms that appeared to have no objective medical explanation. Such use of placebos could convey benefits derived from the placebo effect but the deceptive use of placebo can be problematic because it directly conflicts with contemporary notions of patient autonomy and the practice of shared decision making. Today if physicians attempt to deceive patients by representing placebos as pharmacologically active medications, they risk undermining their patients’ trust. Loss of trust is a serious consequence because it is a foundational component of the patient-physician relationship. If trust is undermined, patients may be less satisfied with their physicians and therefore less likely to consult them when making health-related decisions. Moreover, patients may not adhere to treatment recommendations when trust in their physician had been compromised, thereby adversely affecting patients’ overall health outcomes. Physicians must avoid deception when administering placebos by informing the patient that a placebo may be used.
In my opinion offering a placebo is ethically and morally better than offering absolutely nothing. It is equivalent to offering a drug when the diagnosis or likely efficacy of a drug is highly ambiguous; the outcome of either allows the doctor to perfect the treatment. It seems to me that the ethicality and morality lies not in the pill itself, but in how well a doctor’s actions conform to the ideal of what doctors are for, which I believe is to heal the sick without doing harm. However, the use of unnecessary placebo should be avoided, although it can be acceptable with safety valves.