title: The moral case for the clinical placebo.
abstract: Placebos are arguably the most commonly prescribed drug, across cultures and throughout history. Nevertheless, today many would consider their use in the clinic unethical, since placebo treatment involves deception and the violation of patients' autonomy. We examine the placebo's definition and its clinical efficacy from a biopsychosocial perspective, and argue that the intentional use of the placebo and placebo effect, in certain circumstances and under several conditions, may be morally acceptable. We highlight the role of a virtue-based ethical orientation and its implications for the beneficent use of the placebo. In addition, the definitions of lying and deception are discussed, clarified and applied to the clinical placebo dilemma. Lastly, we suggest that concerns about patient autonomy, when invoked as a further argument against administering placebos, are extended beyond their reasonable and coherent application.
authors.affiliation: Department of Psychiatry, Herzog Hospital, , Jerusalem, Israel.
authors.forename: Azgad
authors.initials: A
authors.lastname: Gold
authors.forename: Pesach
authors.initials: P
authors.lastname: Lichtenberg
mesh_terms: D026686:Beneficence; D008192:Deception; D026689:Ethical Analysis; D028663:Ethical Theory; D004992:Ethics, Medical; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D028681:Moral Obligations; D026706:Paternalism; D026684:Personal Autonomy; D015990:Placebo Effect; D010919:Placebos / Q000008:administration & dosage*; D016896:Treatment Outcome; D035502:Trust; D028722:Virtues
chemical_list: D010919:Placebos
keywords: Autonomy; Clinical Ethics; Informed Consent