What do the experts say...

The following seven quotes are supportive to my thesis that doctors should not use placebos. They collaborate with my subtopics regarding the ethics of using them, the dangers of using them, the price issue and the fact that there are alternatives to their use.

In the health section of the Los Angeles Times it was published that "placebos treatments, as defined by the researchers and the doctors they surveyed, go well beyond the popular notion of placebo as a 'sugar pill'."

In the USA Today "Health and Behavior" section, studies show that "most doctors used actual medicines as a placebo treatment. 41% used painkillers, 38% used vitamins, 13% used antibotics, 13% used sedatives, 3% used saline injections and 2% used sugar pills."

Ebsco's article "Placebo Gives Brain Emotional Break" claims that "according to a new study of placebo-induced reduction of anxiety, such expectations trigger a decline in the brain's emotional responsiveness and marshal pain-numbing neural activity."

Dr. Howard Brody, a medical ethicist and family physician at the University of Texas agrees that it creates a dependance on drugs and causes "kids to grow up thinking that the only way to get better is by taking a pill..."
He then furthers his argument by saying "some doctors worry that giving children 'medicine' for every ache and pain teaches that every ailment has a cure in a bottle."

In a New York Times article, reporter Benedict Carey reflects on an experiment where two groups of people were given the same placebo, one more expensive than the other ($2.50, $0.10). He reported that "85% of those using the expensive pills reported significant pain relief, compared with 61% on the cheaper pills." This is an easy way for doctors and companies to make quick money.

From the American Medical Association handbook and website, there is a copy of the princples of medical ethics that all doctors must abide by. Some of them state that "a physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities...a physician shall, while caring for a patient, regard responsibiility to the patient as paramount...a physician shall...make relevant information available to patients, collegagues and the public..."

Doctors quote in the Chicago Tribune that "the harm comes when antibiotics are dispensed needlessly, heightening the risk that bacteria will develop antibiotic resistance, on of the most dangerous medical phenomenons of our time."

Developing the Argument

In addition to arguing that placebos are dangerous to the patient in many different ways, my other subtopics include that prescribing them is morally and ethically wrong, it makes patients pay money for these medications when the pills themselves have no effect, there are alternative options that could achieve the same effects, and it creates a strong dependence on drugs.

> Prescribing Placebos is Morally/Ethically Wrong
*Composed of three different parts (the AMA Council on Ethical and Judicial Affairs, the AMA Ethics Resource Center, and the AMA Institute for Ethics), the American Medical Association is responsible for establishing policies and guidelines that ensure professionalism and ethical practices.
*Before becoming a doctor, one must agree to follow all of the laws listed under this Association.
*A few include, always putting the patients’ health and well being first, being honest in all professional interactions, reporting a physicians misconduct whether it be engaging in fraud, deception, etc., respecting the law, safeguarding patient confidences
*The use of placebos undermines these laws and if pursued, could be taken to the AMA Ethics Court
* The use of placebos gets in the way of the doctor – patient relationship. It significantly blocks open lines of communication and can lead to mistrust.
> To develop this argument I will further research the AMA and provide a counter act and argument for each law with the use of placebos.

>Patients Are Paying For These Inert Medications
*NYT, there was a study where two different groups of people were given placebos (which they thought to be actual medication) of different costs. One was $2.50 while the other was $0.10.
*More people from the group who paid $2.50 experienced results that were significantly stronger
*When doctors prescribe placebos, they are causing patients to pay for medication that they do not need.
*This can even cause issues with insurance companies if patients are covered because they are unknowingly filing claims for medication that is not necessary. The company is paying for something they could do without, especially in this tight economy.

>There Are Alertnatives
*The placebo effect is described as giving patients “inert” substances as a means to produce results that would usually only result in medically active ingredients
*Giving patients fake medications and making them believe cause the brain to secrete opioids, chemicals used for pain relief
*If the mind/body relationship is really that powerful, then there really is no need for the pills. The pills represent assurance, something in which the doctor could give with no health risks or cost if they just talked to their patients.
*Other methods could convince and calm the patient enough to secrete the opiods without the pills.

>Dependance on Drugs
*Placebos just feed in to the whole misconception that everything can be cured with a drug – for every pain, there is a pill.
*It can easily create a dependence and addiction.
*Doctor's take the easy way out.