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Many Doctors Use Placebos on Patients

Chicago Survey: Nearly Half of Doctors Have Given Patients Dummy Pills or Other Placebos
By
WebMD Health News
Reviewed by Louise Chang, MD

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 studies.

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 "stop complaining."

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 trials.

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