Are Placebos A Betrayal?

[flashl]

In recent years, there’s been a resurgence of interest in placebos. Not the kind that are used to minimize bias in clinical trials, but the kind that doctors knowingly give to patients.

In a recent survey of more than 200 doctors practicing in academic medical centers, 45% reported that they had given placebos to patients in the course of providing clinical care. Nearly all the physicians surveyed agreed with the statement that “placebos have therapeutic effects,” and the condition for which they believed placebos offered the most psychological and physiological benefit was pain.

They endorsed a variety of suggested definitions for placebo substances: half agreed with the statement that placebos are interventions “that are not expected to have an effect through a known physiologic mechanism.” The primary reasons physicians used placebos were to calm patients (18% of the time) and as supplemental treatment (also 18% of the time). One of the particularly noteworthy things about this study is that 92% of the doctors believed that the mechanism of action of the placebo was psychological. They weren’t giving the placebos to anxious patients simply to shut them up; they were invoking a mechanism of healing — the mind-body connection — that they believed in, even though they couldn’t specifically identify how it operated.

This is a sea change from “old school” thinking about how placebos fit into clinical practice. In a 1979 study, a majority of academic physicians reported believing that the use of placebos helped expose patients who were “faking” their symptoms. In contrast, 80% of the doctors in the more recent survey disagreed with the notion that placebos can be used to identify symptoms that have a psychogenic origin.

Reuters

[dweller]

1. do you mean betrayers of the Drug monopolies?

otherwise, what is betrayal in a mind-body connection?

i tend to trust the ten thousand year old healer.
dp

[wtmusic]

2. Except in clinical trials

a patient has the right to know what they're ingesting. Or not.

So yes, especially if they are being charged for real meds.

[Warpy]

3. Lying to a patient is a betrayal, period.

When families would want a diagnosis withheld from a patient, we'd tell them the person in that bed was our patient and that we would answer all questions truthfully and to the best of our ability. If they asked us, we would tell them, in other words.

Some did, some didn't.

People take placebos all the time on their own, from useless herbs and unnecessary vitamins to homeopathic "magic water" to those silly foot pads as seen on TV*. If people are susceptible to the placebo effect and the stuff they're taking isn't hurting them, then there's no problem at all with it.

However, it shouldn't be dispensed by a profession founded on the scientific method and which has to keep a relationship of trust going with the patient. The last thing we need is some hot dog doctor lying to his patients and giving them sugar pills instead of investigating just why they are having pain.

*http://doesitwork.msnbc.msn.com/archive/2008/06/19/1156772.aspx

[sam sarrha]

4. just doing what works without side effects.. wonder if they charge $200 week for em

[DemExpat]

5. I highly value the placebo effect I may be getting from Homeopathy,

herbs, and supplements, as I accept that placebo may be aiding my healing, but would be very pissed if lied to by medical doctors about the medicine I was receiving for a certain condition.

DemEx