Should doctors always tell the truth?
About half of American rheumatologists and internists regularly prescribe placebos for their patients, including active drugs such as sedatives and antibiotics. But they rarely admit it, according to research in the BMJ. The use of placebos has been widely criticised because it is deceptive and therefore violates patients’ autonomy. But supporters argue that they can offer effective treatment for many chronic conditions without necessarily deceiving patients.

"This is the doctor-patient relationship, and our expectations about being truthful about what’s going on and about getting informed consent should give us pause about deception," said Dr. Franklin Miller, one of the authors.

Nonetheless, of the 679 doctors in the survey, 62% believed that using a placebo treatment is ethically acceptable. Half reported using placebos several times a month. Nearly 70% described the treatment to their patients as "a potentially beneficial medicine not typically used for your condition." Only 5% called it a placebo. Most doctors used medicines as a placebo treatment: 41% used painkillers, 38% vitamins, 13% antibiotics, 13% sedatives, 3% saline injections, and 2% traditional sugar pills. Smaller studies in Britain, Denmark and Sweden, have returned similar results. ~ New York Times, Oct 23; AP, Oct 23

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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