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Feeling good about placebos

SEATTLE A Michigan State University medical ethicist believes giving a patient a placebo the old-fashioned way using some kind of "dummy" medication is deceptive and in most cases should not be done.

However, Howard Brody, speaking at the annual meeting of the American Association for the Advancement of Science, also said that nowadays there are more ways to produce a placebo effect than just handing the patient a fake pill, ways that are not only ethical but also effective.

Brody, a professor of family practice at MSU and former director of the university's Center for Ethics and Humanities in the Life Sciences, said health care providers may appear to face an ethical dilemma: Should a placebo be prescribed and the patient lied to about what he or she is receiving, knowing that at least in some cases the placebo can be a powerful means of healing? Or should the provider carry out his or her ethical duty by telling the truth?

Fortunately, he said, the dilemma disappears because there are other ways to produce a placebo effect without using any form of "dummy" medication.

"This new way of thinking defines the placebo effect as a special kind of mind-body interaction that occurs in a health-care setting," Brody said. "Doctors may never prescribe placebos dummy pills but can make use of the placebo effect every time they see a patient. Seeing that the 'placebo effect' does not depend on the 'placebo' is key to making use of its healing potential in an ethical way.

"Features of the healing environment usually include a physician or healer that listens carefully to what you say and gives you a realistic and sound explanation of what is happening to you," he said. "People express care and compassion for your fears and suffering, and you leave feeling more in control of your life and your illness."

In addition, Brody said evidence exists that creating positive feelings in the health care environment goes a long way in tre
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Contact: Tom Oswald
oswald@msu.edu
517-355-2281
Michigan State University
14-Feb-2004


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