Have you ever been given a placebo? In a recent study, the AMA Ethics Board concludes that secret placebo treatment is improper.
The American Medical Association (AMA) Council on Ethical and Judicial Affairs (CEJA) has decided that it is unethical for doctors to offer placebo therapy without patient consent. To be incorporated into the AMA’s Code of Medical Ethics, the AMA House of Delegates, the organization’s national policy-making body, must vote in favor of the ruling. This ruling was reported in the journal Virtual Mentor (Volume 8, page 377).
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A placebo therapy is one that the doctor does not know to be helpful, but a patient believes may be an effective medicine. Sometimes people in clinical studies who take placebo pills improve even more than people taking an actual drug.
While use of inactive placebos is common in research, placebo use in routine clinical practice is controversial. A fictitious scenario presented to explain the policy is that of a 39-year-old woman who complains of fatigue and asks for an energy booster. An unethical response, the CEJA decision indicates, would be to give her an injection of inactive saline (the placebo), calling it a “vitamin boost” that could cure the fatigue. If the famous placebo effect kicks in, she might feel more energetic, but at the cost of being deceived and misinformed. The doctor would have failed to engage her in a truly informed discussion of her problem and her treatment options.
