Abstract
Deliberate use of placebos, defined as treatments without any effect as such, is usually considered unethical. The Council on Ethical and Judicial Affairs of the American Medical Association, for example, states that it “may undermine trust, compromise the patient–physician relationship, and result in medical harm to the patient” (AMA 2018).
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References
Alfano, M. 2015a. Placebo effects and informed consent. American Journal of Bioethics 15: 3–12.
Alfano, M. 2015b. Response to open peer commentaries on “Placebo Effects and Informed Consent”. American Journal of Bioethics 15: W1–W3.
Altman, D.G., and J.M. Bland. 1995. Absence of evidence is not evidence of absence. BMJ 311: 485.
AMA (American Medical Association). Use in clinical practice. https://www.ama-assn.org/delivering-care/use-placebo-clinical-practice. Accessed 1 Jun 2018.
Annoni, M., and F.G. Miller. 2016. Placebo effects and the ethics of therapeutic communication: A pragmatic perspective. Kennedy Institute of Ethics Journal 26: 79–103.
Blease, C. 2015. Authorized concealment and authorized deception: Well-intended secrets are likely to induce nocebo effects. American Journal of Bioethics 15: 23–25.
Bok, S. 2002. Ethical issues in use of placebo in medical practice and clinical trials. In The science of the placebo: Toward an interdisciplinary research agenda, ed. H.A. Guess, A. Kleinman, J.W. Kusek, and L.W. Engel, 53–74. London: BMJ Books.
Brown, W.A. 1998. The placebo effect. Scientific American 278 (1): 90–95.
Carlino, A. 2005. Petrarch and the early modern critics of medicine. Journal of Medieval and Early Modern Studies 35: 559–582.
Carvalho, C., J.M. Caetano, L. Cunha, et al. 2016. Open-label placebo treatment in chronic low back pain: A randomized controlled trial. Pain 157: 2766–2772.
Cheng, Maria. 2013. Many UK doctors give useless drugs, treatments. Times Colonist/Associated Press, March 20. http://www.timescolonist.com/life/health/many-uk-doctors-give-patients-useless-drugs-treatments-authorities-say-that-s-unethical-1.94966. Accessed 1 Jun 2018.
Colagiuri, B., L.A. Schenk, M.D. Kessler, et al. 2015. The placebo effect: From concepts to genes. Neuroscience 307: 171–190.
Ende, J., L. Kazis, A. Ash, and M. Moskowitz. 1989. Measuring patients’ desire for autonomy: Decision-making and information-seeking preferences among medical patients. Journal of General Internal Medicine 4: 23–30.
Evans, H.M., and A.P.S. Hungin. 2007. Uncomfortable implications: Placebo equivalence in drug management of a functional illness. Journal of Medical Ethics 33: 635–638.
Feder, K.E. 2007. Beyond autonomy and paternalism: The caring transparent self. In Autonomy and paternalism. between independence and good intentions, ed. T. Nys, Y. Denier, and T. Vandevelde, 1–29. Leuven: Peeters.
Fent, T., T. Rosemann, M. Fässler, O. Senn, and C.A. Huber. 2011. The use of pure and impure placebo interventions in primary care—A qualitative approach. BMC Family Practice 12: 11.
Fässler, M., M. Gnadinger, T. Rosemann, and N. Biller-Andorno. 2009. Use of placebo interventions among Swiss primary care providers. BMC Health Serv Res 9: 144.
Fässler, M., K. Meissner, A. Schneider, and K. Linde. 2010. Frequency and circumstances of placebo use in clinical practice—A systematic review of empirical studies. BMC Medicine 8: 15.
Gold, H., D.B. Barr, M. Cattell, E.F. DuBois, P.A. Bunn, and W. Modell (eds.). 1947. Cornell conferences on therapy: Use of placebos in therapy. New York: Macmillan.
Hemilä, H. 2013. Vitamin C may alleviate exercise-induced bronchoconstriction: A meta-analysis. BMJ Open 3: e002416.
Hemilä, H., and Elizabeth Chalker. 2013. Vitamin C for preventing and treating the common cold. Cochrane Database Systematic Reviews (1): CD000980.
Hoenemeyer, T.W., T.J. Kaptchuk, T.S. Mehta, et al. 2018. Open-label placebo treatment for cancer-related fatigue: A randomized-controlled clinical trial. Scientific Reports 8: 2784.
Holley, A.D., E. Osland, J. Barnes, A. Krishnan, and J.F. Fraser. 2011. Scurvy: Historically a plague of the sailor that remains a consideration in the modern intensive care unit. Internal Medicine Journal 41: 283–285.
Howick, J., F.L. Bishop, C. Heneghan, J. Wolstenholme, S. Stevens, F.D.R. Hobbs, et al. 2013. Placebo use in the United Kingdom: Results from a national survey of primary care practitioners. PLoS ONE 8 (3): e58247.
Hróbjartsson, A., and M. Norup. 2003. The use of placebo interventions in medical practice: A national questionnaire survey of Danish clinicians. Evaluation and the Health Professions 26: 153–165.
Hróbjartsson, A. 2008. Clinical placebo interventions are unethical, unnecessary and unprofessional. Journal of Clinical Ethics 19: 66–69.
Juraschek, S.P., E. Guallar, L.J. Appel, and E.R. Miller. 2012. Effects of vitamin C supplementation on blood pressure: A meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition 95: 1079–1088.
Justman, S. 2013. Deceit and transparency in placebo research. Yale Journal of Biology and Medicine 86: 323–331.
Kaiser, L., D. Lew, B. Hirschel, R. Auckenthaler, A. Morabia, A. Heald, et al. 1996. Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions. Lancet 347: 1507–1510.
Kam-Hansen, S., M. Jakubowski, J.M. Kelley, et al. 2014. Altered placebo and drug labeling changes the outcome of episodic migraine attacks. Science Translational Medicine 6: 218ra5.
Kaptchuk, T.J., J.M. Kelley, L.A. Conboy, R.B. Davis, C.E. Kerr, E.E. Jacobson, et al. 2008. Components of placebo effect: Randomised controlled trial in patients with irritable bowel syndrome. BMJ 336: 999–1003.
Kaptchuk, T., and F. Miller. 2018. Open label placebo: Can honestly prescribed placebos evoke meaningful therapeutic benefits? BMJ 363: k3889.
Leslie, A. 1954. Ethics and practice of placebo therapy. American Journal of Medicine 16: 854–862.
Lichtenberg, P., U. Heresco-Levy, and U. Nitzan. 2004. The ethics of the placebo in clinical practice. Journal of Medical Ethics 30: 551–554.
Loewy, E. 2005. In defense of paternalism. Theoretical Medicine and Bioethics 26: 445–468.
Louhiala, P. 2009. The ethics of the placebo in clinical practice revisited. Journal of Medical Ethics 35: 407–409.
Louhiala, P. 2012. What do we really know about the deliberate use of placebos in clinical practice? Journal of Medical Ethics 38: 403–405.
Louhiala, P. 2014. Deciding on treatment. In The medical humanities companion volume three: Treatment, ed. P. Louhiala, I. Heath, and J. Saunders, 47–50. Oxford: Radcliffe.
Louhiala, P., H. Hemilä, and R. Puustinen. 2015. Impure placebo is a useless concept. Theoretical Medicine and Bioethics 36: 279–289.
Meissner, K., L. Höfner, M. Fässler, and K. Linde. 2012. Widespread use of pure and impure placebo interventions by GPs in Germany. Family Practice 29: 79–85.
Meynen, G., and G. Widdershoven. 2015. Dealing with placebo effects: A plea to take into account contextual factors. American Journal of Bioethics 15: 19–21.
Nitzan, U., and P. Lichtenberg. 2004. Questionnaire survey on use of placebo. BMJ 329: 944–946.
Novella, S. 2013. Do 97% of UK doctors prescribe placebos? Neurologica Blog. http://theness.com/neurologicablog/index.php/do-97-of-uk-doctors-prescribe-placebos/. Accessed 1 Jun 2018.
Nys, T., Y. Denier, and T. Vandevelde. 2007. Introduction. In Autonomy & paternalism. Reflections on the theory and practice of health care, ed. T. Nys, Y. Denier, and T. Vandevelde, 1–22. Leeuven: Peeters.
O’Neill, O. 2002. Autonomy and trust in bioethics. Cambridge: Cambridge University Press.
Padayatty, S.J., H.D. Riordan, S.M. Hewitt, L.A. Katz, J. Hoffer, and M. Levine. 2006. Intravenously administered vitamin C as cancer therapy: Three cases. Canadian Medical Association Journal 2006 (174): 937–942.
Park, L.C., and U. Covi. 1965. Nonblind placebo trial: An exploration of neurotic patients’responses to placebo when its inert content is disclosed. Archives of General Psychiatry 12: 36–45.
Pellegrino, E. 2009. Physician integrity: Why it is inviolable. In: Connecting American Values with Health Reform. Hastings Center, 18–20. http://www.thehastingscenter.org/Publications/Detail.aspx?id=3528. Accessed 1 Jun 2018.
Philby, C. 2013. The placebo effect: Doctors admit prescribing unproven treatments, unnecessary tests and pills with no active ingredient. The Independent, March 20, 2013. http://www.independent.co.uk/life-style/health-and-families/health-news/the-placebo-effect-doctors-admit-prescribing-unproventreatments-unnecessary-tests-and-pills-with-no-active-ingredient-8542666.html. Accessed 1 Jun 2018.
Raynaud-Simon, A., J. Cohen-Bittan, A. Gouronnec, E. Pautas, P. Senet, M. Verny, and J. Boddaert. 2010. Scurvy in hospitalized elderly patients. Journal of Nutrition, Health, and Aging 14: 407–410.
Roeser, S. 2015. Placebo, nocebo, informed consent, and moral technologies. American Journal of Bioethics 15: 15–17.
Sandler, A.D., and J.W. Bodfish. 2008. Open-label use of placebos in the treatment of ADHD: A pilot study. Child Care and Health Development 34: 104–110.
Schaefer, M., T. Sahin, B. Berstecher, and J.P. van Wouwe. 2018. Why do open-label placebos work? A randomized controlled trial of an open-label placebo induction with and without extended information about the placebo effect in allergic rhinitis. PLOS ONE 13(3): e0192758.
ScienceDaily. U.S. doctors regularly prescribe real drugs as placebo treatments, study claims. ScienceDaily, October 25, 2008. http://www.sciencedaily.com/releases/2008/10/081023195216.htm. Accessed 1 Jun 2018.
Schneider, C.E. 2005. Some realism about informed consent. Journal of Laboratory and Clinical Medicine 145: 289–291.
Schwartz, P.H. 2015. Placebos, full disclosure, and trust: The risks and benefits of disclosing risks and benefits. American Journal of Bioethics 15: 13–14.
Shapiro, A., L.A. Morris. 1978. The placebo effect in medical and psychological therapies. In Handbook and psychotherapy and behavior change: An empirical analysis, 2nd edn., 369–410, eds. S.L. Garfield, A.E. Bergin. New York: Wiley.
Sherman, R., and J. Hickner. 2008. Academic physicians use placebos in clinical practice and believe in the mind–body connection. Journal of General Internal Medicine 23: 7–10.
Tauber, A.I. 2005. Patient autonomy and the ethics of responsibility. Cambridge, Mass; London: MIT Press.
Tilburt, J.C., E.J. Emanuel, T.J. Kaptchuk, and F.A. Curlin. 2008. Prescribing ‘placebo treatments’: Results of national survey of US internists and rheumatologists. British Medical Journal 337: a1938.
Wang, Y., X.J. Liu, L. Robitaille, S. Eintracht, E. MacNamara, and L.J. Hoffer. 2013. Effects of vitamin C and vitamin D administration on mood and distress in acutely hospitalized patients. American Journal of Clinical Nutrition 2013 (98): 705–711.
Young, J., A. De Sutter, D. Merenstein, G.A. van Essen, L. Kaiser, H. Varonen, et al. 2008. Antibiotics for adults with clinically diagnosed acute rhinosinusitis: A meta-analysis of individual patient data. Lancet 371: 908–914.
Zhang, M., L. Robitaille, S. Eintracht, and L.J. Hoffer. 2011. Vitamin C provision improves mood in acutely hospitalized patients. Nutrition 27: 530–533.
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Louhiala, P. (2020). Clinical Use of Placebos. In: Placebo Effects: The Meaning of Care in Medicine. The International Library of Bioethics. Springer, Cham. https://doi.org/10.1007/978-3-030-27329-3_4
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