Placebos in practice

doi:10.1136/bmj.329.7472.927

BMJ 2004;329:927-928 (23 October), doi:10.1136/bmj.329.7472.927

Editorial

Placebos in practice

Doctors use them, they work in some conditions, but we don'tknow how they work

The first 150 words of the full text of this article appear below.

Placebo comes from the Latin for "I will please." Pleasing apatient would seem to be a good thing to do. Yet considerablecontroversy exists about the use of a biologically inert orirrelevant substance with therapeutic intent. Nitsan and Lichtenbergshow in this issue (p 944) that placebos are often used in modernmedicine.¹ Their survey of 89 doctors and nurses providing hospitalbased and ambulatory care in Israel found that 60% used placebosin their practice, most often (43%) to fend off an "unjustified"demand for medication, to calm a patient (38%), as an analgesic(38%), or, more problematically, as a diagnostic tool (28%).The paper makes it clear that the placebo pleases modern doctors.Should it? If the placebo effect is real, is it right to useit?

Most of medicine used placebos at one time. Medicine in the20th century was supposed to end . . . [Full text of this article]

David Spiegel, Willson professor

Stanford Medical Center, Stanford, CA 94305-5718, USA (dspiegel@stanford.edu)

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