Friday, January 04, 2008

Placebo use common

One of the most fascinating things in medicine is how someone can think they are taking medicine and in many cases get better when in reality they were not taking any medicine at all, in fact they were taking what is called a placebo!

A placebo is:
When referring to medicines, placebo is a preparation which is pharmacologically inert but which may have a therapeutical effect based solely on the power of suggestion. It may be administered in any of the ways in which pharmaceutical products are administered.[3]

To simplify this let me put it this way. A placebo is a pill that has no medicine! Yet someone taking it is made to believe that it is medicine.

Placebo use common, doctors say in U.S. survey

CHICAGO (Reuters) - Placebos are a surprisingly common prescription, according to a U.S. study in which nearly half of the doctors surveyed said they had doled out a dummy pill at some point.

Researchers at the University of Chicago said on Thursday the study raises ethical questions and suggests a need for greater recognition and understanding of placebo use.

"It illustrates that doctors believe expectation and belief have therapeutic potential," said Rachel Sherman, a medical student at the University of Chicago, whose study was published in the Journal of General Internal Medicine.

The idea behind placebos is that when patients think they are getting an effective treatment, they sometimes feel better, even though the pill has no proven benefit.

They are often used in clinical trials to compare the benefits of drugs, and many times patients taking placebos show some improvement. But few studies have shown how doctors use placebos in routine practice.

Sherman and Dr. John Hickner, a family medicine professor at the University of Chicago, sent surveys to 466 internists at three Chicago-area academic medical centers. About half, or 231, responded.

Of those, 45 percent said they had used a placebo during their clinical practice, a number that surprised the researchers. But 12 percent of those surveyed said placebos should never be used.

"I think this shows that it strikes a chord among physicians. We may underestimate the body's natural healing potential," Sherman said in a telephone interview. "This shows that doctors may think that, too."

But Sherman said the practice brings up ethical issues, including whether a doctor has an obligation to provide patients with informed consent.

Of respondents who reported using a placebo in clinical practice, 34 percent said they told the patients the substance was something that "may help and will not hurt."

About a third gave other information to patients including, "this may help you but I am not sure how it works."

Nineteen percent said it was a "medication," and 9 percent called it "a medicine with no specific effect." Only 4 percent of the doctors said, "it is a placebo."

Part of the reason doctors are not forthcoming about giving a placebo is that in order for it to work, patients need to believe it can help, Sherman said.

One way around this dilemma is to ask all new patients for their consent in advance. "The patient could say no. Then you avoid any of these ethical questions," Sherman said.

Could this be a way to lessen the cost of health care? Simply give people cheap pills that have no medicine and watch them get better! Yes, that is a joke but I do find the story very interesting.

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> posted by Trevor Hammack @ 8:23 AM   0 comments links to this post


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