Thursday, October 22, 2009

Placebos, Doctors, and Patients

We know that the placebo effect is real. Some people will actually get better if they think they are being treated. It is not that they think they're getting better, they actually are.

So, if I am ill and my doctor thinks that given what he knows of me and my ailment, that it might be good to try a placebo before another treatment which might be more expensive, risky, have serious side effects, can he?

The placebo effect requires deception and deception makes a relationship unequal. Is my doctor my partner in health care or my medical master? If it is the first, it seems that he or she is not legitimate in fooling me, even for my own good because it is an affront to my autonomy, to my being an adult in the relationship. If the doctor occupies a special position in the relationship, like a parent to a child, then it seems ok for him or her to lie and tell me I'm getting a new very effective treatment.

In the case of medical studies where placebos are a necessary part of good double blind study, the participants are told that they may be receiving a placebo, but in this case, it would undermine the effectiveness.

So, would it be ok for the doctor to prescribe a placebo?