| Submit your comments on this article |
| -Short Attention Span Theater- |
| Half of American Doctors Give Patients Placebos Without Telling Them |
| 2008-10-25 |
| About half of American doctors in a new study regularly give their patients placebo pills without telling them. That contradicts advice from the American Medical Association, which recommends doctors only use treatments to which patients have given their informed consent. "It seems like doctors are doing things they shouldn't be doing," said Irving Kirsch, a professor of psychology at the University of Hull, who has studied the use of placebos. Kirsch was not linked to the research, published Friday in the British Medical Journal. "Doctors may be under a lot of pressure to help their patients, but this is not an acceptable shortcut," he said. Placebos were defined in the study as treatments whose benefits derived from patients' beliefs they would work, not from the actual drug itself. They included painkillers, vitamins, antibiotics, sedatives and sugar pills. Studies have shown that patients given a fake treatment can often improve, despite the pill having no known impact on their condition. Researchers at the U.S. National Institutes of Health sent surveys to a random sample of internists and rheumatologists across the country. They received 679 responses, of which 62 percent believed that using placebo treatment was ethically acceptable. Half of the doctors reported using placebos several times a month. Nearly 70 percent of those who did so described the treatment to their patients as "a potentially beneficial medicine not typically used for your condition." Only five percent of doctors explicitly called it a placebo treatment. Jon Tilburt, the study's lead author, said he believed the doctors surveyed were representative of internists and rheumatologists across the U.S. No statistical work was carried out to establish whether the study results would apply to other medical specialists like pediatricians or surgeons. In the survey, doctors were asked if they would recommend a sugar pill for patients with chronic pain if it had been shown to be more effective than no treatment. Nearly 60 percent of doctors said they would. Smaller studies done elsewhere, including Britain, Denmark and Sweden have found similar results. The U.S. research was paid for by the National Center for Complementary and Alternative Medicine and the Department of Bioethics at the National Institutes of Health. "It's a disturbing finding," said Franklin G. Miller, director of the research ethics program at the National Institutes of Health and one of the paper's authors. "There is an element of deception here which is contrary to the principle of informed consent." The authors said that most doctors probably reasoned that doing something was better than doing nothing. Other situations where placebos were used included doctors giving vitamins to patients with difficult conditions, such as chronic fatigue syndrome, or giving antibiotics to patients with bronchitis to make them feel better. Scientists still don't understand how the placebo effect works — whether it is just psychological or whether there is also a physiological reaction to the treatment. Irving said it might be possible to get the psychological impact without using a fake pill. "If doctors just spent more time with their patients so they felt more reassured, that might help," he said. Experts also don't know if the placebo effect would be undermined if patients were explicitly told they were getting a dummy pill. But some patients said the truth was paramount. "I would feel very cheated if I was given a placebo," said Ruth Schachter, an 86-year-old London resident who has had skin cancer. "I like to have my eyes wide open, even if it's bad news," she said. "If I'm given something without being warned what it is, I certainly would not trust the doctor again." |
| Posted by:Anonymoose |
| #20 What does the patient care as long as they get better. In fact, Placebo's have ZERO side effects, so if you can get better with a placebo you don't have to worry about your kidneys dying on you. Another attempt of the illuminaties trying to scare us that someone is out to get us. Doctors do the best with what they have to work with and sometimes it just takes a little positive reinforcement to get a person better. |
| Posted by: Sheba Shumble8238 2008-10-25 22:06 |
| #19 Another ethical problem with doctors prescribing placebos: some do it because they think their patients have a psychosomatic disorder instead of a real disease. They figure giving placebos will (a) make the patient happy, and (b) make the patient go away. Problem is, a lot of so-called psychosomatic disorders are real -- the doctor just hasn't done the research. Instead of sending them to someone who might actually believe they're not crazy, they charge for ineffective treatments. Not good. |
| Posted by: cinderkeys 2008-10-25 17:14 |
| #18 TW I am on high dose (14gr/day) fish oil/omega-3 to raise HDL-C and it has done that. Other things started changing with my health (inflammation reduction, neurological function etc). I looked for a possible cause for these changes after the fact and one possible reason is that they also could be due to fish oil. My take on OTC supplements is that they can indeed help, but only at several times the recommended dose that is on the label. |
| Posted by: Minister of funny walks 2008-10-25 16:33 |
| #17 Unless these doctors are prescribing otherwise harmless drugs off-label, I don't see how this could possibly work. Except for samples, I get all my scripts from Express Scripts after one of my doctors faxes the prescription in. Having looked up that the scripts are all prescribed "on label" my question is this: Is there some sort of double-secret-probation-handshake that codes for "send the sugar pill"instead of the med.? |
| Posted by: Minister of funny walks 2008-10-25 16:22 |
| #16 The red placebos might be more effective and less harmful than some of the drugs that are dispensed. |
| Posted by: JohnQC 2008-10-25 15:28 |
| #15 Studies have proven red placebos are more effective than those of any other color. I eagerly await the marketing of sustained-release placebos (just take one a month), the placebo patch, and extra-strength placebos (double the inactive ingredients for just 40% more). |
| Posted by: Anguper Hupomosing9418 2008-10-25 14:43 |
| #14 Are nutriceuticals effective or placebo? Often enough a doctor will suggest taking Co-Q10 or extra vitamin B-12 or ginko biloba with the statement that it might help the patient. In some cases there is research behind the suggestions, in other cases very small scale studies at best. And yet, if the patient's symptoms respond positively, how is the doctor to test if the cause was biochemical or placebo? |
| Posted by: trailing wife 2008-10-25 14:30 |
| #13 I'll have to look at the study, but at first blush I don't believe it. |
| Posted by: Steve White 2008-10-25 13:23 |
| #12 Since when did pain killers and antibiotics and sedatives become placebos? |
| Posted by: Darrell 2008-10-25 12:31 |
| #11 "All placebos are not the same," Eli Lilly spokesman Giles French said. "Pacifex is the only placebo that's green and shaped like a triangle. Pacifex: A doctor gave it to you." FDA Approves Sale of Prescription Placebo |
| Posted by: eLarson 2008-10-25 11:48 |
| #10 Dr Bernanke says his 600 billion bailout WILL work... |
| Posted by: Bright Pebbles 2008-10-25 11:16 |
| #9 "I trust my physician, it's the 'Placebos' from Washington I'm concerned about." Amen! |
| Posted by: Minister of funny walks 2008-10-25 11:09 |
| #8 Half of American Doctors Give Patients Placebos Without Telling Them. I trust my physician, it's the 'Placebos' from Washington I'm concerned about. |
| Posted by: Besoeker 2008-10-25 10:33 |
| #7 Just give the patients a lillypop and tell them they'll be alright, don't be such a crybaby. Then, back at the golf course! |
| Posted by: anonymous5089 2008-10-25 10:20 |
| #6 Makes sense. Since half the time doctors don't know what is wrong with their patient. |
| Posted by: phil_b 2008-10-25 10:18 |
| #5 Seems like they at least ought to tell them. |
| Posted by: .5MT 2008-10-25 10:04 |
| #4 Think about this. Do they charge for placebos at the same rate they charge for the real medicine? Does the bill reflect the same cost? I doubt placebos costs as much as the real thing, so where does the difference go to? |
| Posted by: Procopius2k 2008-10-25 10:01 |
| #3 Dammer, now my glasses don'twork! |
| Posted by: .5MT 2008-10-25 09:58 |
| #2 Medicine is expensive. That seems like fraud to me. |
| Posted by: Betty 2008-10-25 09:45 |
| #1 To make matters a lot worse, diagnosis isn't easy. Internists face a multitude of similar symptoms with different causes, patients who evidence some symptoms and not others as well as extraneous conditions that appear to be symptoms, and multiple and overlapping conditions. Misdiagnosis is very common. Patients also have strange and unpredictable expectations of treatment, and in America often assume that physicians can 100% repair, unrepairable conditions. Rheumatologists are especially under pressure, because inflammatory conditions are unique to individuals, and different parts of the same person often respond differently to the same treatment. The conditions are also often reactive to barometric pressure and to a lesser extent temperature. |
| Posted by: Anonymoose 2008-10-25 09:44 |