Placebos play an important role in research as controls to test the efficacy of medical interventions; a pill or procedure can only be considered effective if it works better than the placebo. But should placebos be part of actual treatment? Is a doctor who prescribes a sugar pill – even if it works to lessen symptoms – technically deceiving the patient?
In recent post at Clinical Correlations, NYU medical student Brian D. Clark discusses this issue and highlights some recent research:
One argument against the routine use of placebos (such as sugar pills for improvement of subjective symptoms) is that by its very nature, a placebo is thought to require some element of concealment or deception. Previous work has shown a beneficial effect of placebos in patients with IBS. To test whether concealment was necessary for this effect, Kaptchuk and colleagues randomized patients with IBS to either an “open-label placebo” treatment group or no treatment at all. The patients in the open-label placebo group were told that “the placebo pills were made of an inert substance, like sugar pills, that had been shown in clinical studies to produce significant improvement in IBS symptoms through mind-body self-healing processes.” They found that patients given the open-label placebo had significantly reduced symptom severity compared to the no-treatment group. Thus, placebo-like treatment may be helpful in certain conditions such as IBS. This study suggests that the therapeutic effect is due the patients’ perception that the potential treatment, even if inert, has been shown to be helpful. This highlights the possibility that the patient-doctor relationship itself may be beneficial in certain conditions if the patient believes the doctor is trying to help him or her.