Prescribing placebo treatments is common practice and seen as acceptable, according to new findings.
Dr Jon Tilburt of the National Institutes of Health, Bethesda, USA, and colleagues investigated attitudes about placebo treatments among doctors in the US.
For their study, a placebo was defined as "a treatment whose benefits derive from positive patient expectations and not from the physiological mechanism of the treatment itself".
The researchers surveyed 679 randomly-selected internal medicine physicians and rheumatologists. Between 46 and 58 per cent of the doctors reported prescribing placebo treatments on a regular basis, and most (62 per cent) believed this is "ethically permissible".
Many reported using over-the-counter analgesics and vitamins as placebo treatments. A smaller proportion used saline or sugar pills, while some gave antibiotics or sedatives.
It was rare for the doctors to describe the drugs to patients as placebos. More often they said that the placebo treatment was a "potentially beneficial medicine" or a "treatment not typically used for their condition".
The study is published on the website of the British Medical Journal. Dr Tilburt and colleagues write: "Physicians might not be fully transparent with their patients about their motivations, but largely avoid prescribing sugar pills and saline." They suggest that doctors "might have mixed motivations for recommending such treatments".
"Whether, or under what circumstances, recommending or prescribing placebo treatments is appropriate remains a topic for ethical and policy debates," they conclude.
Tilburt, J. C. et al. Prescribing ‘placebo treatments’: results of national survey of US internists and rheumatologists. The British Medical Journal, 2008;337:a1938.
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