It's like my head

My personal opinion is that lying to patients or misrepresenting the state of the evidence in any way is always unethical and must be scrupulously avoided. Telling the patient that what you are prescribing is a placebo wouldn’t excuse you, because the very fact that you are giving it has persuasive meaning for the patient. I think attempts to elicit a placebo effect should be only used in conjunction with an effective treatment. Words should be used carefully, and the focus should be on general measures that bolster the doctor/patient relationship and enhance the patient’s trust, like spending more time with the patient and showing a greater interest and sympathy.

We face two major challenges. First, we need to improve the ways in which we communicate the results of placebo research so the public won’t think we are willy-nilly recommending placebo deceptions of any kind in clinical practice. Second, we need to answer some difficult questions about the ethical limits of taking various actions to increase expectations. The answers will not be easy. Let the discussion begin.