Patients almost always assume that their doctors are prescribing medicine proven to treat their ailments. However, that's not always the case.
Almost half of doctors surveyed in a study admitted to having used placebos in their clinical practice, according to a recent study by Penn alum and University of Chicago medical student Rachel Sherman and John Hickner, a professor at Chicago.
Their study of 231 Chicago-area doctors shows that the medical community is not entirely averse to prescribing placebos to patients.
A placebo is a substance administered to a patient that is believed to have no real effect on the condition being treated. Placebos are widely used as tools in experimental medical research, but little is known about their use with patients who are not taking part in research trials.
The survey has raised issues that, until recently, have largely flown under the radar.
Ninety-six percent of the respondents said they believe in the therapeutic effects of placebos and in some sort of mind-body connection. However, medical professionals disagree when it comes to the ethics of placebo use.
According to the American Medical Association's Web site, "physicians may use placebos for diagnosis or treatment only if the patient is informed of and agrees to its use."
However, patient knowledge of placebo use can diminish or eliminate its benefits. There is also some ambiguity regarding the definition of "informed consent" when it comes to placebos.
Patient-doctor trust and communication is of utmost importance to many, said Philosophy professor Adrienne Martin.
"I think we now have a patient community that has the expectation of honesty, as opposed to 40 years ago," she said. "I would like to see people finding ways to make use of placebos without being dishonest."
Other doctors have more liberal definitions of full disclosure.
"For the patients' own good, I can understand trying placebos and then telling the patient afterwards," said Arthur Caplan, director of Penn's Center for Bioethics. "It's important to talk about what you did and why, after the fact. Most doctors don't do that."
Martin said placebo use in clinical care is an important issue that deserves discussion.
"It's a conversation that needs to start happening," she said, also suggesting that a study of patient opinions regarding placebo use could provide insight for doctors.
Students said patients should be made aware of the potential for placebos to be used in treatment.
"If the patient is going to the doctor for medication, they at least need to know [a placebo] is a possibility," said Engineering junior Ashley Stein.
Now, Sherman, who graduated from the College in 2002, is working on a national randomized survey on placebos in order to obtain more generalized results.
