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September 3, 2013

What would you think if you found out the pain medication you had been taking for the past few months was a placebo instead of a “real medication?” Research has shown that some people get better, not because of the pharmacologic or physiologic effects of a pill, but because they believe they will benefit from it (i.e., the placebo effect). Some believe it is unethical for a health care provider to prescribe a placebo treatment, since it deceives the patient and therefore violates patient autonomy. However, a recent study by Hull and colleagues (2013) asked patients what they thought about placebo treatments, and the results may surprise you.

The researchers conducted a cross-sectional survey of 853 patients in the Kaiser Permanente health system, asking their thoughts about placebo treatments. Over 76% of those surveyed thought it was okay for health care providers to prescribe a placebo if it caused no harm, and nearly two-thirds of respondents indicated they themselves would take placebos! Yet, respondents also valued honesty, believing if patients questioned the medication, the health care provider should disclose to them that it was a placebo.

The clinical treatment of patients is complex. Health care providers often face a difficult choice: to prescribe medications which could also have harmful side effects or to prescribe placebos which could violate a patient’s autonomy. Perhaps, as these authors suggest, health care professionals should engage their patients in these ethical discussions to decide the appropriate place of placebos in therapy.

British Medical Journal article

Guest article by Dr. Aleda Chen, Assistant Professor of Pharmacy Practice

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