Placebo therapy without patient consent unethical
Employing placebo therapy without patients' knowledge or cooperation is unethical, the American Medical Association's Council on Ethical and Judicial Affairs states in a new report. The report was met with some disagreement by the association's House of Delegates when it was introduced, with delegates asking the ethics council to reconsider its stand against a practice that members say is part of standard practice. The report emphasizes that physicians "must maintain patients' trust by avoiding the use of deception and properly informing patients when a placebo may be used in their treatment."
According to the ethics council report, some physicians prescribe placebo rather than active drugs or medical devices after reports from placebo-controlled clinical trials indicate patients randomized to placebo showed some benefit. When the substitution is made without patient knowledge and consent, the council report states, an ethical line is crossed because patients believe they are receiving active therapy.
The House of Delegates referral committee that heard the report countered that it heard testimony citing many examples where patient knowledge of the use of placebo "would nullify the placebo effect." The report was referred back to the ethics council, which is expected to refine the report's language and resubmit it to the House of Delegates later in 2006 or at the 2007 annual meeting.
The report only addresses the use of placebo therapy in clinical practice; the recommendations do not apply to placebo in clinical trials. (A description of the Council for Ethical and Judicial Affairs report, "Placebo Use in Clinical Practice," is available in the action report of the AMA House of Delegates 2006 Annual Meeting, at www.ama-assn.org.)
Employing placebo therapy without patients' knowledge or cooperation is unethical, the American Medical Association's Council on Ethical and Judicial Affairs states in a new report.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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