In a study by 5 medical ethicists from National Institutes of Health (NIH), it was found that 46-58% of physicians said they prescribe placebos on a regular basis, and almost two-thirds stated that it was ethically permissible to do so. In many studies, the placebo beneficial effect is 30-40%. If a placebo works for a patient, is that part of the art of medicine? If the patient gets better, does it matter if a placebo is used? The problem arises when placebo medications, such as over-the-counter pain drugs, are used that have significant side effects such as gastritis and kidney failure. Another problem is one of definition. If a nutritional supplement is prescribed that has potential benefit for an individual patient but that benefit has not been definitively proven, that could be called a “placebo” by physicians who do not believe in supplements. By limiting prescribing to proven evidence-based medicine, a doctor will miss the opportunity to significantly help a good number of his or her patients. If only 1/3 of patients respond to a safe, inexpensive therapy, those 1/3 are still helped, despite what evidence-based medicine concludes. They should not be forbidden to take a therapy that is helpful for them.
See Family Practice News(click here, subsription required) 12/1/09, p. 50 or BMJ 2008:337:a1938.
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