BMJ 1994;309:667 (10 September)

Letters

The placebo effect Wrong patients receive treatment

EDITOR, - Vernon M S Oh leaves us with a medical dilemma: on the one hand he tells us that we "should consider giving a placebo to appropriate patients," but, earlier in the review, he tells us that "selecting the patients most likely to benefit from placebo is difficult."1 In practice, doctors tend to give placebos to the least appropriate patients. These include neurotic patients, who are least likely to respond2; demanding patients who have an investment in not responding; and chronically ill patients who suffer from what psychologists have called placebo sag. Most placebos are probably given unwittingly by the doctor,3 and this folie a deux makes the placebo particularly effective. In this context, and with many active treatments, the placebo effect may be at its greatest but goes unrecognised.

Placebos' effectiveness is largely a function of the attitudes and skills of the doctor and his or her . . . [Full text of this article]


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Relevant Article

The placebo effect: can we use it better?
Vernon M S Oh
BMJ 1994 309: 69-70. [Extract] [Full Text]

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