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Placebo Pain MedicationEthical and Practical Considerations
Irwin Kleinman, MD, FRCPC;
Peter Brown, MD, FRCPC;
Larry Librach, MD, CCFP
Arch Fam Med. 1994;3(5):453-457.
Abstract
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.
Author Affiliations
From the Centre for Bioethics, University of Toronto (Drs Kleinman and Librach), the Departments of Psychiatry (Drs Kleinman and Brown) and Family and Community Medicine (Dr Librach), Mt Sinai Hospital, University of Toronto, Toronto, Ontario. Dr Brown is now in private practice in Toronto.
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