title: The ethics of placebo treatments in clinical practice: a reply to Glackin.
abstract: In 'Placebo treatments, informed consent, and "the grip of a false picture"' Shane Nicholas Glackin argues that if a physician offers a patient an inert placebo with the following disclosure, this is compatible with informed consent and is not deceptive: 'I would like to offer you a pill which I believe can help lessen your suffering. I do not know exactly how it works. I have other pills to offer whose mechanism is clearer, but I am not sure that they will work better for you, and they may also entail more serious side effects'. According to Glackin, telling patients that the recommended treatment is an inert placebo is providing incidental information, analogous to telling a patient the chemical details of an active drug. He argues that this information would influence a patient's decision only if she was 'in the grip of a false picture' that inert drugs do not have physical effects on patients' bodies. We contend that this disclosure typically is incompatible with informed consent and typically is deceptive. We give an example of a transparent placebo disclosure, that is, a disclosure that is compatible with informed consent and is not deceptive.
authors.affiliation: Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Barnhill
authors.affiliation: Weill Cornell Medical College, New York, NY, USA.
authors.forename: Franklin G
authors.initials: FG
authors.lastname: Miller
mesh_terms: D030881:Disclosure / Q000941:ethics*; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics*; D010919:Placebos
chemical_list: D010919:Placebos
keywords: Autonomy; Clinical Ethics; Informed Consent