A major study on the use of placebos has concluded the fake pills sometimes work better than real medicines and recommended that doctors give them out more often – even without explicitly telling their patients.
The German research is in stark contrast to guidance from US and British authorities, who say using placebos without the patient’s consent is unethical. Placebo pills are often made from things such as sugar, flour or dust, although doctors also use other things including vitamins and herbal supplements.
According to the German Medical Association, placebos do not come with any nasty side effects and could be the last hope for patients with hard-to-treat ailments where no good medicines exist.
Peter Scriba, chairman of the German Medical Association’s advisory board, said placebos could help patients with mild anxiety, depression, chronic inflammatory problems, pain and asthma.
Experts said placebos work best for diseases where there is a subjective component like perceptions of pain - and that they would not work for other problems such as broken bones or cancer. Dr Scriba said placebos shouldn’t be used for conditions where an effective therapy exists and that doctors must tell patients they are getting something unusual, but he added that doctors are not obliged to use the word “placebo”.
Some experts were horrified by the less-than-forthright approach. “That’s what I call lying,” said Ted Kaptchuk, an associate professor of medicine at Harvard University. “I’m not saying it’s wrong, but it would be unacceptable in the US.”
Last year, Mr Kaptchuk and colleagues published a study that found people with irritable bowel syndrome who knowingly took a placebo still got better, providing some proof that doctors do not always have to deceive patients when giving them dummy pills.
Previous surveys have found up to half of the doctors in Denmark, Britain and the US regularly give their patients placebos without telling them, although British medical authorities completely reject the idea that placebos might be valuable.
“We don’t agree with the use of placebos at all because, by definition, they’re a medication that has no value,” Tony Calland, chairman of the British Medical Association’s medical ethics committee, said. “Using placebos isn’t scientific. It sends medicine back into the 19th century.”