Applying evidence to support ethical decisions: is the placebo really powerless?.
Using placebos in day-to-day practice is an ethical problem. This paper summarises the available epidemiological evidence to support this difficult decision. Based on these data we propose to differentiate between placebo and "knowledge framing". While the use of placebo should be confined to experimental settings in clinical trials, knowledge framing--which is only conceptually different from placebo--is a desired, expected and necessary component of any doctor-patient encounter. Examples from daily practice demonstrate both, the need to investigate the effects of knowledge framing and its impact on ethical, medical, economical and legal decisions.
Clinical Economics, University Hospital Ulm, 89075 Ulm, Germany. franz.porzsolt@medizin.uni-ulm.de
Franz
F
Porzsolt
Nicole
N
Schlotz-Gorton
Nikola
N
Biller-Andorno
Anke
A
Thim
Karin
K
Meissner
Irmgard
I
Roeckl-Wiedmann
Barbara
B
Herzberger
Renatus
R
Ziegler
Wilhelm
W
Gaus
Ernst
E
Pöppe
D003657:Decision Making / Q000941:ethics; D004341:Drug Evaluation / Q000941:ethics / Q000379:methods; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D008962:Models, Theoretical; D010817:Physician-Patient Relations / Q000941:ethics; D010919:Placebos; D016032:Randomized Controlled Trials as Topic / Q000941:ethics* / Q000379:methods; D036302:Therapeutic Human Experimentation / Q000941:ethics*
D010919:Placebos