Sunday, October 26, 2008

the placebo affect

I heard this breaking news the other day on the radio, but thanks again to Azúcar for sending a link to this report about how half of American doctors surveyed admitted to prescribing placebos. (I'm especially happy for the link because this is where I tell you I almost have a crush on Dr. Nancy. She and John Stossel are my most trusted purveyors of news and information. They could tell me just about anything and I would believe it.)

"It's a disturbing finding," said Franklin G. Miller, director of the research ethics program at the U.S. National Institutes Health and one of the study authors. "There is an element of deception here which is contrary to the principle of informed consent."

"Doctors may be under a lot of pressure to help their patients, but this is not an acceptable shortcut," said Irving Kirsch, a professor of psychology at the University of Hull in Britain who has studied the use of placebos.

When I first heard this, I was appalled. But I know doctors are under incredible pressure to prescribe. I've seen it. Given the overuse of antibiotics and the state of the new superbugs I see a place for prescribing a placebo to someone who insists on not leaving the office without a prescription in hand (you may think I exaggerate, but believe me, I do not.)

And here's another thing, what about "informed consent?" Does everyone really have that anyway? There are two kinds of people in this world: Those who will take whatever the doctor gives them without question--in which case it really doesn't matter--and those who will ask the doctor and then their pharmacist and then still march right home and Google whatever it was they were prescribed before they take it--in which case a doctor likely wouldn't get away with prescribing a placebo anyway.

And finally,
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 said they would.

While I am one of those who want information and want to be in the know, I see the value in the potential psychological effect of a placebo. In cases where there is no other treatment available, I think using a placebo could be considered a humane approach (unless some pharmaceutical company is making big bucks off your px.

What say you?


wendy said...

I'm bugged by the whole notion of being prescribed something with the doctor's intention being giving me a placebo. Tell it to me straight, for crying out loud.

On the other hand, dh and I just had a "discussion" about homeopathic medications the other day, and he insists that any effects are placebo. Well, they work for me, so placebo or not, I'm all for them. However, I don't think those who "prescribe" homeopathic remedies believe they are prescribing placebos.

This makes me wonder what my doctor has done. I sometimes really hate the medical profession. Grrrr....

swedemom said...

This is both really interesting and disturbing. Is it ethical to prescribe a placebo to a patient who insists on medication? If you consider the patient has demanded a prescription and the doctor doesn't want to do more harm by antibiotics that won't help, then I don't think it is unethical.

I am disturbed by our culture's desperate need for a pill to promote and aid healing.

Justine said...

I've wondered a time or two, and wondered if I should feel silly or somehow humiliated by the experience. I even have researched some meds I've taken to find out if they really are medicine.

It is pretty disturbing.

becks said...

Being one that works in a doctors office, i can tell you that i have never seen the doctor i work for prescribe a placebo. but, i wouldn't doubt some doctors doing that. Some patients are just plain rediculous in their expectations. For example: i have some mothers who call in and say their little 2 month old baby has a cough and wants us to prescribe something for it or asking what cough medicine they can give her. HELLO! she's 2 months old! there is not an OTC cough medicine you can give her! people just want a quick fix for no effort what so ever.