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Conclusion
It is clear from the varied results and opinions expressed in these studies that there remains a significant amount of work to be done to completely elucidate the physiologic or psychological basis of the placebo effect and to determine the actual magnitude of the effect in the absence of any confounding factors. The claims of some investigators suggest that the placebo effect is among the most important concepts in medicine and certainly has a lasting role in clinical trials. The importance of the placebo effect in relation to alternative therapies has not been extensively studied and there appears to be considerable rhetoric on both sides of the argument. Proponents of alternative therapies argue that the placebo effect has no relation to alternative therapies and that pharmaceutical treatments are no more effective than placebo. A similar argument is made by people who do not support alternative therapies, in essence they argue that the benefit seen with alternative therapies is primarily due to the placebo effect.
There is a considerable amount of discussion as to the ethics of administering placebos as treatment. Reported use of placebos among U.S. physicians is low, surveys of physicians in some other countries have showed very high numbers of physicians that use placebos as a primary treatment option. A survey in Jerusalem found that 60% of physicians used placebos and 94% of these physicians found placebos to be "generally or occasionally effective" in their patients (Nitzen). A separate study found that 48% of Danish physicians use placebos at least 10 times a year. Several reasons are given by physicians who prescribe placebos to their patients including: the desire to calm a demanding patient, to provide the patient with a illusion of treatment when none was deemed warranted by the physician or as a diagnostic tool to evaluate the authenticity of patient complaints. The primary ethical concern is that of the inherent deception of the patient when prescribing a placebo as treatment. Proponents of the use of placebos argue that it is in the patient's best interest to not receive medications or medical care that is not medically indicated and that the efficacy of the placebo speaks for itself. |
