Ethics Alert: Many Doctors Prescribe Placebos

A disturbing study has been published indicating that many doctors prescribe placebos instead of efficacious medications to their patients. From the story:

Many rheumatologists and general internal medicine physicians in the US say they regularly prescribe “placebo treatments” including active drugs such as sedatives and antibiotics, but rarely admit they are doing so to their patients, according to a study on bmj.com...

The authors report that among the 679 physicians (57%) who responded to the survey half of them said they prescribed “placebo treatments” on a regular basis. Most physicians (62%) believed the practice to be ethically acceptable and were happy to recommend or prescribe placebo treatments.

The most commonly used placebo treatments prescribed in the past year were over the counter painkillers (41%) or vitamins (38%). Some of the physicians reported using antibiotics (13%) and sedatives (13%) as placebos, only 3% reported using sugar pills.

Interestingly, among those who prescribe placebo treatments, most doctors (68%) said they typically describe the placebo treatments to patients as “a potentially beneficial medicine or treatment not typically used for their condition”, only rarely did they admit to explicitly describing them to patients as “placebos”.

Man, there are a whole heap of problems here, the following of which leap immediately to mind. First, this is lying to patients and it interferes with informed consent and refusal. Second, patients are receiving drugs that may cause side effects for no purpose other than to think they are receiving treatment. Third, patients are paying for drugs they don’t need. Fourth, such “treatments” can cause harm, such as increasing the likelihood of antibiotic resistant bacteria. Fifth, it is a way of shining patients on without finding out their real underlying issues. (Why do I think this might happen to women more than men?) Sixth, it could lead to patients thinking they were nuts when they still had symptoms, perhaps preventing them from seeking further help.

Yes, I know there is such a thing as a placebo effect, which is why they are used in human medical trials, where they are appropriate. But even if this does work once in a while, it is wrong.

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