The ethical question of replacing the patients medicine with placebo without their knowledge

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The ethical question of replacing the patients medicine with placebo without their knowledge

Doctors of old prescribed them for demanding patients who wanted some sort of pill or injection for their illnesses.


A typical placebo might be a pill containing only sugar or bread or an injection containing only salt and water, and a placebo "sham" operation was one in which the patient was cut open and then sewn right back up.

All of these so-called dummies were given to placate the patient, not to fix the illness-hence the Latin name placebo, which means "I shall please. They would compare the effects of a new pill, for example, with those of a placebo pill that looked exactly the same but had no known active ingredients.

Placebos established a baseline, showing, for example, the effects of pill-taking per se. If the placebo pill worked as well as the new pill, then the active ingredients in the new pill weren't all that active. The experiments typically were carried out "double blind": Many clinical trials no longer include placebo controls.

Instead, the controls might be an available treatment that is partly effective but not quite good enough, the current standard therapy in a range of doses, several doses of the new test therapy, or no treatment at all.

Placebo - Wikipedia

Here are examples of three clinical trials in which the use of placebo controls has raised complex ethical questions. It is caused by the human immunodeficiency virus HIV. Newborns whose mothers are infected with HIV can acquire the infection from their mothers at the moment of birth. Clinical trials in showed that, if a pregnant woman took the drug AZT in pills during the last 12 weeks of pregnancy and as an injection during labor and if the baby received AZT during the first six weeks of life, the baby had a much-reduced chance of becoming infected with the virus.

Thus, an enormous public outcry arose in when American and African researchers gave a placebo, rather than AZT, as a control to pregnant women in Africa who were infected with HIV and were participating in clinical trials.

The researchers argued that "standard" treatments for AIDS for these women were no treatments at all. The researchers were evaluating lower and fewer doses of AZT in the studies to see if low doses might be effective.

Such doses might be affordable and accessible for the African women and other poor women around the world.

The ethical question of replacing the patients medicine with placebo without their knowledge

The researchers argued that placebo controls were appropriate, that they constituted the local "standard" therapy, and that they would provide answers faster than would other types of controls.

Some people argue that it is unethical to use different standard treatments for rich and poor women. Others say that western researchers should not impose "ethical imperialism" on women in other countries and that each country should determine its own standards for what is ethical in research.

Still others argue that, because placebo trials end more quickly than do trials in which different doses of AZT are compared and because placebo trials use fewer subjects than do other trials, in the long run, more children would be saved through placebo trials.

Still others counter that no person should be a means to an end, however positive that end might be. Placebo Effects Placebos are said to be dummies-dummy pills, injections, surgeries, and other treatments. The pills and injections contain no known active ingredients, and the surgeries do nothing-they involve an incision and its repair.

No one knows why this is so.

The "placebo effect" is an authentic, active effect for a range of diseases and conditions-nausea, various types of pains, coughs, headaches, anxieties, colds, diabetes, ulcers, depressions, and even some psychoses. Placebos also can cause nasty side effects, the so-called nocebo effects, for "I shall harm.

What accounts for placebo and nocebo effects? Many studies suggest that, for certain individuals, an encounter with a doctor or other healer is enough treatment to initiate a recovery.

The ethics of the placebo in clinical practice | Journal of Medical Ethics

The doctor may write a prescription, but the patient recovers even without filling it. Or the patient will feel better after undergoing a series of diagnostic tests. One explanation for placebo effects is that the hopefulness that the patient feels while being treated translates into a physiological surge of specific hormones and other biochemicals in the body.Nov 27,  · Doctors admit prescribing placebos.

placebo to calm patients, without medicating them so they could diagnose their condition more accurately after the patients had regained their composure. Mar 22,  · A new study finds that a good number of doctors have given their patients placebo.

Whether it’s ethical or not may depend on the type. Is It Ethical For Doctors To Prescribe Placebo. While discussions of the ethics of the placebo have usually dealt with their use in a research context, the authors address here the question of the placebo in clinical practice. It is argued, firstly, that the placebo can be an effective treatment.

Secondly, it is demonstrated that its use does not always entail deception. Finally guidelines are . Jan 03,  · A survey suggests many doctors give dummy pills or other placebos to their patients, furthering the debate about a practice that some experts consider unethical.

Many Doctors Use Placebos on.

Included References

Since most medical experimentations was conducted by doctors on their patients, the use of placebos for scientific purposes was regulated according to the same moral principles adopted in clinical medicine: if a covert placebo was deemed useful for advancing the doctor's knowledge, and sufficiently innocuous or beneficial for the patient, its.

Can a doctor prescribe a placebo, and would pharmacies carry them? What did the doctors actually tell their patients? Over two-thirds of those who prescribed placebos told patients they were getting "medicine not typically used for your condition but which might benefit you." Use of a placebo without the patient's knowledge may.

Placebo Therapies: Are They Ethical? – Science-Based Medicine