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Indian Journal of Medical Sciences, Vol. 63, No. 11, November, 2009, pp. 519 Letter To Editor The placebo therapy Aggarwal Sourabh University College of Medical Sciences, New Delhi Code Number: ms09096 PMID: 20075555 DOI: 10.4103/0019-5359.58883 Sir, I read the article "Use of placebo: knowledge, attitude and practice among medical practitioners" [1] with great interest. It is really commendable that authors have studied the use of placebo by medical practitioners in the Indian setup. I applaud Shah et al. for their efforts. I would like to raise my concern over some serious issues relating to this subject. The study points to an important ethical issue, viz., that of informed consent involved in the use of placebo therapy. Although the American Medical Association in its "Code of Medical Ethics: Opinion 8.083" [2] condemns the use of placebo therapy without the patients′ informed consent, what happens in clinical practice is quite the reverse. As indicated by the study, only single general practitioner revealed the exact nature of therapy. It compromises the autonomy of patients regarding treatment given to them. The practitioners though need to obtain informed consent can still give placebo therapy without revealing the exact placebo medicine and the time it′s given and still achieve the same therapeutic advantage. [2] Thus placebo effect can be achieved without compromising the autonomy and trust of the patient. Also, the increasing trend of use of impure placebos as compared to pure placebos can lead to increasing side effects and thus cause more harm than good to the patients. Such practices should preferably be avoided. Also, the placebo therapy though useful in its own limits opens the gate for the ′art of quackery.′ The use of placebo therapy is widely exploited by the quacks for minor ailments. As a result, the patients turn to quacks even for more serious disorders, which are not relieved by placebo effects and need appropriate scientifically approved treatment for their cure. In fact, most of the quackery thrives on the placebo effect only by explanations and promises given to patients and by instilling the confidence and belief in the minds of patients regarding their remedies. These kinds of practices threaten the harmony of patient-physician relationship, and this issue needs to be immediately addressed so that the quality of medical care improves. References
Copyright 2009 - Indian Journal of Medical Sciences |
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