Sturnam
Bluelighter
- Joined
- Aug 12, 2008
- Messages
- 738
Overview
Placebos, or "sugar pills," have been used in medicine since ancient times. Today, most placebos are given in clinical trial studies for new drugs. A study in the January 2008 issue of the Journal of General Internal Medicine found that 45 percent of Chicago, Illinois, internists report they have used a placebo for patients at some time during their clinical practice. Only 4 percent of those admitted they were giving a placebo.
Questions and answers
Is this legal?
Dr. Sanjay Gupta, CNN chief medical correspondent: It's not illegal, but it is unethical to prescribe a placebo to someone who has no idea that he or she is getting a sugar pill. Even so, in a recent survey done at the University of Chicago Medical Center, 45 percent of internists who filled out the anonymous questionnaire said they had used a placebo at some time during their clinical practice. Of those, only 4 percent told their patients it was a placebo.
Most said it was a pill that would help but not harm them. Most admitted that they gave the placebo to patients who were upset when they came to the hospital. They used the placebo to calm patients, without medicating them so they could diagnose their condition more accurately after the patients had regained their composure.
Ethically, the question is whether physicians should be giving patients medication the individuals think is something else. Should doctors be liable if the placebo does not work, or can do a patient harm? The American Medical Association takes a strong stance against doctors prescribing placebos without a patient's knowledge.
What exactly is a placebo, and how does it work?
Gupta: Placebo means "I shall please" in Latin; they've been used for centuries. They are dummy pills. Doctors usually prescribe them to patients who complain of symptoms for which doctors cannot find an underlying cause. They really have no physical effect. It's more a psychological than physiological result -- a mind-over-matter thing. The patient thinks he's getting help, when in reality it's his mind that is helping ease his symptoms, not the phony drug.
Most recently, placebos have been used to test new drugs and new drug therapies. Patients in clinical trials are aware they may be getting a placebo. In such a trial, some patients get a placebo, while others get the real drug. Drug manufacturers make every effort to make the placebos look like the drug they are mimicking, so the patient has no idea what, if any, drug he or she is taking. By comparing the effects of placebos and real drugs, scientists can tell whether the drug is really working.
Isn't that called the placebo effect?
Gupta: Yes, some patients who have been on placebos swear they've been helped, even though they are taking a sugar pill. Placebos aren't just being used in drug trials. A recent study looked at placebo surgery, where patients underwent arthroscopic surgery for osteoarthritis of the knee. Part of the trial group had the arthroscopic surgery, while the other group had only the incision made with no surgery on the knee, and then were sewn up to make it look like they had surgery. Researchers found those patients who had surgery did no better and had no less pain than those who only got the incision, but not the surgery. Again, it was mind over matter.
Source: http://www.cnn.com/2008/HEALTH/dailydose/11/27/placebo.ethics/index.html
I bolded the parts I found interesting. They claim it's mind over matter, which i guess it is, but that doesn't change the fact that the 'matter' is still actually changed. Especially backed up with the knee-surgery study.
Now the question is, is this ethical? It seems like if people got the same benefits as surgery, but without the damage, recovery, and costs associated with actual surgery, wouldn't this be helpful? In some ways it seems like the drug companies want to make 'placebo treatment' unethical because they wouldn't be able to patent it.
Second, I don't believe that placebo would go against the "do no harm" oath. after all, not all medicines will work for every patient, and placebo is the only medicine with no side effects. So it seems like the outcomes would either be: A) condition remains the same, no harm done, switch to a 'real' medicine. or B) placebo works, costs less, same benefits to the patient.
However, I think it's also important to determine what cases the placebo treatment should be used in. For example, substituting placebo for medicine to treat MRSA seems like a bad idea, or using it instead of Lipitor for high cholesterol.
I think that the most useful application would be for low-danger mental health diseases, because it seems like those are largely mentally based, so there should be no reason to give people powerful medicines that may not even help them. For example, instead of giving a person with mild anxiety a lifelong prescription of xanax, give them "xanax" and tell them it's real, and I believe that they will actually get better.
Your thoughts on this matter?
Placebos, or "sugar pills," have been used in medicine since ancient times. Today, most placebos are given in clinical trial studies for new drugs. A study in the January 2008 issue of the Journal of General Internal Medicine found that 45 percent of Chicago, Illinois, internists report they have used a placebo for patients at some time during their clinical practice. Only 4 percent of those admitted they were giving a placebo.
Questions and answers
Is this legal?
Dr. Sanjay Gupta, CNN chief medical correspondent: It's not illegal, but it is unethical to prescribe a placebo to someone who has no idea that he or she is getting a sugar pill. Even so, in a recent survey done at the University of Chicago Medical Center, 45 percent of internists who filled out the anonymous questionnaire said they had used a placebo at some time during their clinical practice. Of those, only 4 percent told their patients it was a placebo.
Most said it was a pill that would help but not harm them. Most admitted that they gave the placebo to patients who were upset when they came to the hospital. They used the placebo to calm patients, without medicating them so they could diagnose their condition more accurately after the patients had regained their composure.
Ethically, the question is whether physicians should be giving patients medication the individuals think is something else. Should doctors be liable if the placebo does not work, or can do a patient harm? The American Medical Association takes a strong stance against doctors prescribing placebos without a patient's knowledge.
What exactly is a placebo, and how does it work?
Gupta: Placebo means "I shall please" in Latin; they've been used for centuries. They are dummy pills. Doctors usually prescribe them to patients who complain of symptoms for which doctors cannot find an underlying cause. They really have no physical effect. It's more a psychological than physiological result -- a mind-over-matter thing. The patient thinks he's getting help, when in reality it's his mind that is helping ease his symptoms, not the phony drug.
Most recently, placebos have been used to test new drugs and new drug therapies. Patients in clinical trials are aware they may be getting a placebo. In such a trial, some patients get a placebo, while others get the real drug. Drug manufacturers make every effort to make the placebos look like the drug they are mimicking, so the patient has no idea what, if any, drug he or she is taking. By comparing the effects of placebos and real drugs, scientists can tell whether the drug is really working.
Isn't that called the placebo effect?
Gupta: Yes, some patients who have been on placebos swear they've been helped, even though they are taking a sugar pill. Placebos aren't just being used in drug trials. A recent study looked at placebo surgery, where patients underwent arthroscopic surgery for osteoarthritis of the knee. Part of the trial group had the arthroscopic surgery, while the other group had only the incision made with no surgery on the knee, and then were sewn up to make it look like they had surgery. Researchers found those patients who had surgery did no better and had no less pain than those who only got the incision, but not the surgery. Again, it was mind over matter.
Source: http://www.cnn.com/2008/HEALTH/dailydose/11/27/placebo.ethics/index.html
I bolded the parts I found interesting. They claim it's mind over matter, which i guess it is, but that doesn't change the fact that the 'matter' is still actually changed. Especially backed up with the knee-surgery study.
Now the question is, is this ethical? It seems like if people got the same benefits as surgery, but without the damage, recovery, and costs associated with actual surgery, wouldn't this be helpful? In some ways it seems like the drug companies want to make 'placebo treatment' unethical because they wouldn't be able to patent it.
Second, I don't believe that placebo would go against the "do no harm" oath. after all, not all medicines will work for every patient, and placebo is the only medicine with no side effects. So it seems like the outcomes would either be: A) condition remains the same, no harm done, switch to a 'real' medicine. or B) placebo works, costs less, same benefits to the patient.
However, I think it's also important to determine what cases the placebo treatment should be used in. For example, substituting placebo for medicine to treat MRSA seems like a bad idea, or using it instead of Lipitor for high cholesterol.
I think that the most useful application would be for low-danger mental health diseases, because it seems like those are largely mentally based, so there should be no reason to give people powerful medicines that may not even help them. For example, instead of giving a person with mild anxiety a lifelong prescription of xanax, give them "xanax" and tell them it's real, and I believe that they will actually get better.
Your thoughts on this matter?
