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Its the Placebo Stupid

Posted in Skepdude by Skepdude on October 24, 2008

According to this article at The Seattle Times:

About half of American doctors in a new survey say they regularly give patients placebo treatments – usually drugs or vitamins that won’t really help their condition. And many of these doctors are not honest with their patients about what they are doing, the survey found.

…………………

Half the doctors reported using placebos several times a month, nearly 70 percent of those described the treatment to their patients as “a potentially beneficial medicine not typically used for your condition.” Only 5 percent of doctors explicitly called it a placebo treatment.

…………………

Some doctors believe placebos are a good treatment in certain situations, as long as patients are told what they are being given. Dr. Walter Brown, a professor of psychiatry at Brown and Tufts universities, said people with insomnia, depression or high blood pressure often respond well to placebo treatments.

Ok, I don’t intend on making any comments on the ethical issues, but I do have a little comment. Based on my , admittedly layman’s, understanding of the placebo effect the patient must think they are getting something that works, in order for the placebo effect to work. So then what the hell does it mean for a doctor to prescribe placebos but at the same time to be “honest with their patients about what they are doing”? How is it supposed to work if the doctors tells the patient that the pill should not work? Will that not nullify the placebo effect?

Further, according to the survey only 5% of doctors explicitly called it a placebo treatment, which makes the effort useless. You can’t prescribe a placebo, and tell your patient that it is a placebo and still except it to have an effect on the patient. Am I the only one who thinks this does not make any sense?

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One Response

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  1. trrll said, on October 27, 2008 at 6:52 PM

    So then what the hell does it mean for a doctor to prescribe placebos but at the same time to be “honest with their patients about what they are doing”? How is it supposed to work if the doctors tells the patient that the pill should not work? Will that not nullify the placebo effect?

    This is a case where a doctor’s responsibility to provide effective therapy and his obligation to be honest are in conflict. But there are ways to finesse it. A doctor can mention something ineffective but benign, like a vitamin or homeopathic preparation, and say something like, “There is no accepted medical treatment for your condition. Some patients say that this makes them feel batter. From the standpoint of medical science, I don’t understand how it could help, but it couldn’t hurt. You might try it and see what it does for you.”


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