Editing Placebo (section)

===In medical practice===
The practice of doctors prescribing placebos that are disguised as real medication is controversial. A chief concern is that it is deceptive and could harm the doctor–patient relationship in the long run. While some say that blanket consent, or the general consent to unspecified treatment given by patients beforehand, is ethical, others argue that patients should always obtain specific information about the name of the drug they are receiving, its side effects, and other treatment options.<ref>{{cite journal | vauthors = Asai A, Kadooka Y | title = Reexamination of the ethics of placebo use in clinical practice | journal = Bioethics | volume = 27 | issue = 4 | pages = 186–93 | date = May 2013 | pmid = 22296589 | doi = 10.1111/j.1467-8519.2011.01943.x | s2cid = 11300075 }}</ref> This view is shared by some on the grounds of [[Autonomy#Medicine|patient autonomy]].<ref>{{cite journal | vauthors = Chua SJ, Pitts M | title = The ethics of prescription of placebos to patients with major depressive disorder | journal = Chinese Medical Journal | volume = 128 | issue = 11 | pages = 1555–7 | date = June 2015 | pmid = 26021517 | doi = 10.4103/0366-6999.157699 | pmc = 4733778 | doi-access = free }}</ref> There are also concerns that legitimate doctors and pharmacists could open themselves up to charges of fraud or malpractice by using a placebo.<ref>{{cite journal|last1=Malani|first1=Anup |title=Regulation with Placebo Effects|journal=Chicago Unbound|date=2008|volume=58|issue=3 |pages=411–72 |pmid=19353835 |url=https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=2640&context=journal_articles|access-date=30 March 2018}}</ref> Critics also argued that using placebos can delay the proper diagnosis and treatment of serious medical conditions.<ref>{{cite journal | vauthors = Altunç U, Pittler MH, Ernst E | title = Homeopathy for childhood and adolescence ailments: systematic review of randomized clinical trials | journal = Mayo Clinic Proceedings | volume = 82 | issue = 1 | pages = 69–75 | date = January 2007 | pmid = 17285788 | doi = 10.4065/82.1.69 }}</ref>

Despite the abovementioned issues, 60% of surveyed physicians and head nurses reported using placebos in an Israeli study, with only 5% of respondents stating that placebo use should be strictly prohibited.<ref>{{Cite journal|last1=Nitzan|first1=Uriel|last2=Lichtenberg|first2=Pesach|date=2004-10-23|title=Questionnaire survey on use of placebo|journal=BMJ: British Medical Journal|volume=329|issue=7472|pages=944–946|doi=10.1136/bmj.38236.646678.55|issn=0959-8138|pmid=15377572|pmc=524103|doi-access=free}}</ref> A ''British Medical Journal'' editorial said, "that a patient gets pain relief from a placebo does not imply that the pain is not real or organic in origin{{Spaces}}...the use of the placebo for 'diagnosis' of whether or not pain is real is misguided."<ref name="Spiegel">{{cite journal|vauthors=Spiegel D|date=October 2004|title=Placebos in practice|journal=BMJ|volume=329|issue=7472|pages=927–8|doi=10.1136/bmj.329.7472.927|pmc=524090|pmid=15499085}}</ref> A survey in the United States of more than 10,000 physicians came to the result that while 24% of physicians would prescribe a treatment that is a placebo simply because the patient wanted treatment, 58% would not, and for the remaining 18%, it would depend on the circumstances.<ref name=kane>[http://www.medscape.com/viewarticle/731485_7 Doctors Struggle With Tougher-Than-Ever Dilemmas: Other Ethical Issues] Author: Leslie Kane. 11/11/2010</ref>

Referring specifically to [[homeopathy]], the [[House of Commons of the United Kingdom]] Science and Technology Committee has stated:{{Blockquote|In the Committee's view, homeopathy is a placebo treatment and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice—which the Government claims is very important—as it means patients do not have all the information needed to make choice meaningful. A further issue is that the placebo effect is unreliable and unpredictable.<ref name=inquiry_cfm>{{cite web |author1=UK Parliamentary Committee Science |author2=Technology Committee |url=http://www.parliament.uk/business/committees/committees-archive/science-technology/s-t-homeopathy-inquiry/ |archive-url=https://web.archive.org/web/20120224202602/http://www.parliament.uk/business/committees/committees-archive/science-technology/s-t-homeopathy-inquiry/ |archive-date=2012-02-24 |title=Evidence Check 2: Homeopathy }}</ref>}}

In his 2008 book ''[[Bad Science (Goldacre book)|Bad Science]]'', [[Ben Goldacre]] argues that instead of deceiving patients with placebos, doctors should use the placebo effect to enhance effective medicines.<ref name="bad-science">{{cite book | first = Ben | last = Goldacre |title=Bad Science |publisher=Fourth Estate |year=2008| chapter=5: The Placebo Effect |isbn=978-0-00-724019-7}}</ref> [[Edzard Ernst]] has argued similarly that "As a good doctor you should be able to transmit a placebo effect through the compassion you show your patients."<ref>{{cite journal | title = Empathy and ethics: five minutes with Edzard Ernst | journal = The BMJ | volume = 360 | issue = 1 | pages = k309| date = January 2018 | pmid = 29371199| doi = 10.1136/bmj.k309 | last1 = Rimmer | first1 = Abi | s2cid = 3511158 }}</ref> In an opinion piece about homeopathy, Ernst argues that it is wrong to support [[alternative medicine]] on the basis that it can make patients feel better through the placebo effect.<ref name="Ernst-homeopathy"/> His concerns are that it is deceitful and that the placebo effect is unreliable.<ref name="Ernst-homeopathy">{{cite news|title=No to homeopathy placebo | newspaper=The Guardian|url=https://www.theguardian.com/commentisfree/2010/feb/22/science-homeopathy-clinical-trials|date=22 February 2010|access-date=29 April 2019}}</ref> Goldacre also concludes that the placebo effect does not justify alternative medicine, arguing that unscientific medicine could lead to patients not receiving prevention advice.<ref name="bad-science"/>
Placebo researcher [[Fabrizio Benedetti]] also expresses concern over the potential for placebos to be used unethically, warning that there is an increase in "quackery" and that an "alternative industry that preys on the vulnerable" is developing.<ref name="Benedetti">{{cite journal |last1=Benedetti |first1=Fabrizio |title=The science of placebos is fuelling quackery |journal=Knowable Magazine |date=3 March 2022 |doi=10.1146/knowable-030222-3 |s2cid=247265071 |url=https://knowablemagazine.org/article/society/2022/science-placebos-fuelling-quackery |access-date=17 March 2022|doi-access=free }}</ref>