Many Doctors Use Placebos on Patients
Chicago Survey: Nearly Half of Doctors Have Given Patients Dummy Pills or Other Placebos
Jan. 3, 2008 -- A survey released Wednesday suggests many doctors give dummy
pills or other placebos to their patients, furthering the debate about a
practice that some experts consider unethical.
Nearly half the doctors surveyed at three Chicago-area medical institutions
reported that they have used placebos in medical practice. While the survey was
confined to about 230 doctors, the results closely track those of similar
Doctors said they had administered a variety of placebos to patients,
including vitamins, low-dose drugs, and in some cases simple
sugar tablets. Almost 20% of doctors said they had used the pills to calm
patients, 15% said they used placebos to satisfy patients'
"unjustified" demands for treatment, and 6% to get patients to
The ability of such treatments to ease suffering or alter body processes --
known as the placebo effect -- is well-documented. Doctors often learn in
medical school that the mere act of administering treatment can affect patients
even before an active drug has time to work.
"I think it's the very act of comforting a patient that may lead to the
clinical benefits that are desired," says study researcher Rachel Sherman,
a medical student at the University of Chicago Pritzker School of Medicine.
Experimental vs. Clinical Use
Placebos are widely used in research trials as a way to control for the
influence of the placebo effect. In the case of drug trials, one study group
may be given an active drug while another group gets identical treatment
with only the active ingredient missing. In theory this lets researchers study
only the active ingredient while canceling out the placebo effect.
But the use of placebos also raises questions. While study volunteers are
usually told they could receive a placebo as part of the experiment's design,
few patients are informed in this way. That's mainly because the mere knowledge
that a pill is a placebo is usually enough to cancel out the placebo effect.
And that lack of information could undermine a patient's right to informed
consent, some experts say.
"I think it's unethical," says John Kusek, PhD, a senior scientific
advisor at the National Institute of Diabetes and Digestive and Kidney Diseases
who has studied the placebo effect and the use of placebos in clinical
Even if placebo treatment works, it still represents a "slippery"
ethical ground because patients are not told they're getting a placebo instead
of a "real" drug, he says.
"There's still an honesty you have to have whether they're in a trial or
they're a patient of yours," Kusek says.
In this study, 4% of the doctors told patients "it is a placebo"
while 34% told patients that the placebo was "a substance that may help but
will not hurt."
Many doctors surveyed said they believed that other placebos (defined as
treatments with an unknown or nonspecific mechanism of action) such as
meditation, prayer, or complementary medicine could have both a psychological
and physiological benefit for patients. That suggests that "a growing
number of physicians believe in the idea of a mind-body connection," the
researchers concluded in the study, which is published today in the Journal
of General Internal Medicine.
While the study suggested that many doctors have used placebos, there was
little evidence that the practice was frequent. Less than 10% said they had
used placebos more than 10 times.