Israeli clinicians keen on using placebos in treating patients

Three out of five Israeli clinicians report using placebos – inactive treatments or drugs – in treating patients, despite the medical profession's official disapproval of their use, say the authors of a BMJ Online First paper this week.

Over two-thirds of respondents to the researchers' survey admitted they told patients they were receiving genuine medication, and 94% felt placebos were generally or occasionally effective.

The study from Jerusalem surveyed hospital doctors, head nurses and family doctors in community clinics. Circumstances for using placebos varied widely, including diagnosing patients as well as prescribing medication. Respondents also reported using placebos for a wide range of conditions, from anxiety and vertigo, to asthma and even angina.

Significantly only one in twenty respondents felt that placebos should be banned on ethical grounds, while most considered using them in certain circumstances. This raises important ethical questions say the authors, given "the deception involved in administering a placebo".

Within the medical profession placebos are officially frowned upon, and some institutions have banned clinicians from using them. However this study suggests their use is frequent and rising, say the authors. Used wisely, placebos may have a genuine role in treating patients, they suggest. The time has come for the profession to acknowledge their use, so that an open debate on their effectiveness, and the ethics of their application, can take place.

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