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Is it Ethical for Doctors to Prescribe Placebos?

-October 31, 2008

A recent study conducted by the National Institute of Health (NIH) has found that around half of all doctors in the U.S. regularly prescribe placebos to their patients, rather than prescribing clinically tested prescription medication.

While the results of this survey may sound shocking, particularly to patients who trust their doctors' recommendations, they are contingent upon the definition of "placebo" used in the survey.

"Placebo" Defined
For the purposes of this NIH survey, a placebo was defined as any medication or homeopathic remedy that hasn't undergone clinical studies to prove that it works as a treatment for a particular condition. Consequently, according to this definition, the following would be considered placebos:

• multivitamins
• sedatives
• herbal and/or dietary supplements
• over-the-counter pain relievers
• antibiotics, when prescribed for viral infections (If prescribed for bacterial infections, antibiotics aren't placebos, as they've been clinically proven to effectively fight these conditions)

It's important to note that the NIH's definition of placebo is a more detailed, stricter definition than the one that most people think of when they think of placebos, as the widely accepted definition of placebo is "a sugar pill."

The Debate: Should Doctors Prescribe Placebos?
The findings of this survey, along with the definition of placebo used, has raised an interesting debate within the medical community: Is it ethical for doctors to prescribe (or suggest) that their patients use medications and/or supplements that aren't clinically proven to work?

According to Dr. Ezekiel Emmanuel, one of the leading researchers conducting the NIH study, it is unethical for doctors to prescribe placebos. Emmanuel (and others who side with placebo prescriptions being unethical) contends that doctors should not prescribe anything unless it has been proven to work.

However, other medical experts disagree with Emmanuel's opinion. These doctors, professors and researchers say that prescribing supplements, multivitamins and other "placebos" can:

• Be effective treatment options when prescription medications fail to work (or when no particular cause or condition can be identified as the source of patients' discomfort)

• Boost patients' confidence and outlook, as the act of taking them can make patients more optimistic and, in some cases, help them get better.

According to those who think placebo prescriptions are ethical, what's the harm in prescribing things like vitamins since such placebos won't cause any harmful side effects?

As this debate continues to ripple through the medical community, experts are suggesting that patients discuss any questionable prescriptions with their doctors. For those who may still have questions, seeking a second or third opinion from other doctors is recommended.

(CNN Health News)

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