Survey Says

After my last posts about placebos, I was interested in what the general opinion of placebo ethics might be. It seemed that my opinions and those of majority of doctors did not match up based on the following image.

For this reason, I created and distributed a survey to gauge the opinions of my peers. Fifty-three people responded to the survey. I will examine the results of the survey in my final two posts before my conclusion post due to their relevance to the superiority of antidepressants over other treatments namely placebos.

The first question: Placebos are used to determine the effectiveness of medicine in many studies. A double blind study involves a group of patients with a condition who will be administered either a placebo or the actual medicine. Neither the doctors nor the patients know who is being given medicine and who is being given placebo until the end of the trial. The placebo effect successful responses and the actual medicine successful responses are compared to determine the clinical worth of the actual medicine. Do you consider this an ethical use of the placebo effect?

The majority of people (83%) considered this ethical, including me. The rest of the people either considered it unethical (7.5%) or did not have an opinion (9.4%). I thought these results were unsurprising and I asked the question mainly to present how placebos are usually used.

The second question: Now consider a basic doctor-patient relationship completely separate from clinical trials. Would it be ethical for a doctor to promote a treatment primarily to increase the patient's confidence in that treatment and thus the likelihood that the patient will experience a helpful placebo effect?

This is a more interesting question. A doctor's positive presentation of a procedure or treatment can seriously affect a patient's confidence, and thus possibly the placebo effect the patient experiences. What can that hurt? The answer is less clear. This is especially relevant in the case of depression, in which many patients are consistently hopeless and demoralized. Should the doctor be getting the patient's hopes up or is it worth the benefit to over-represent the possibility for success? I would even argue that in prescribing any treatment the doctor must advocate it to a certain extent so where do you draw the line?

This was still voted ethical though by a smaller margin (only 62.3%). 34% of survey takers considered this unethical and 3.8% were unsure.

A link to the survey is provided in the sidebar. More information will be provided in my next post.