Placebo pain medication. Ethical and practical considerations
I. Kleinman, P. Brown and L. Librach
Centre for Bioethics, University of Toronto, Ontario.
The placebo effect on pain is a complex phenomenon. The unconsented use of
placebo pain medication, however, raises concerns given the risks both to
patient trust and to the medical profession's reputation in condoning
deception, the inherent distastefulness of deception, the misuse of
placebos that occurs, and the fact that the information obtained is often
of negligible value. The main justification given for using placebos is
based on the assumption that they are effective and beneficial to patients.
We argue that placebo pain medication should be prescribed to patients only
with their informed consent in scientifically rigorous single-patient
studies. The results of such trials would constitute a particularly useful
way of resolving uncertainty in the treatment of patients whose pain is
poorly controlled.
