pills, doctor prescribe placebos

Doctors’ Placebo Prescriptions Have Some Crying Foul

October 27, 2008 06:45 AM
by Emily Coakley
Studies published this year suggest that prescribing placebos without their patients’ knowledge is a common practice for doctors, news that has made some angry.

Placebos in Regular Use

The Associated Press reports that a study published last week in BMJ (British Medical Journal) indicates that in contradiction to American Medical Association guidelines, about half of doctors in the United States “say they regularly give patients placebo treatments,” generally without the patients’ knowledge or consent.

Franklin G. Miller, one of the study’s authors and director of the National Institutes of Health’s research ethic program called the results, “disturbing.”

Doctors, the authors said, “probably reasoned that doing something was better than doing nothing,” AP said.

A January 2008 study from the Journal of General Internal Medicine provides more evidence for this trend; of nearly 500 faculty doctors surveyed at medical schools in Chicago, more than 200 said they had prescribed placebos.

According to a Time magazine article about the study, “Among the reasons the doctors gave: to calm a patient down, to respond to demands for medication that the doctor felt was unnecessary, or simply to do something after all other clinical treatment options had failed.”

Nearly all the doctors surveyed said prescribing placebos was acceptable, even if that doctor hadn’t actually done so.

According to Time, the AMA “tells its members that ‘[p]hysicians may use placebos for diagnosis or treatment only if the patient is informed of and agrees to its use.’”

Opinion & Analysis: Anger with doctors

A blogger known as Skepdude, writing on the blog Skepfeeds, asked, “Based on my, admittedly layman’s, understanding of the placebo effect the patient must think they are getting something that works, in order for the placebo effect to work. So then what the hell does it mean for a doctor to prescribe placebos but at the same time to be “honest with their patients about what they are doing”? How is it supposed to work if the doctors tells the patient that the pill should not work? Will that not nullify the placebo effect?”

Others had stories about being prescribed a placebo and being deceived by doctors. The blogger who writes One Snarky Chica With Issues said she was once prescribed medicine and told to take a day off work after getting a strep test. When she returned to the same clinic months later, she learned the test had been negative, “As in, no need to have missed work for a day and no need to have paid for prescription meds.

After the University of Chicago study came out earlier this year, Meg Marco wrote on the site Consumerist about a time when she had insomnia and her doctor prescribed half a Benadryl, an over-the-counter medication, although she mentioned to him that she’d tried it without success. Marco’s pharmacist alerted her before filling the prescription.

“Oh boy, was I pissed. Actually, I'm still pissed! Rar!” Marco wrote.

Reference: BMJ and JGIM studies


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