BMJ  2008;336:1020 (3 May), doi:10.1136/bmj.39564.454502.C2

Views & Reviews

The thinking doctor’s guide to placebos

Rudiger Pittrof, consultant in integrated sexual health and HIV1, Ian Rubenstein, general practitioner2

1 Department of Reproductive and Sexual Health Care, Town Clinic, Enfield, Middlesex, 2 Eagle House Surgery, Ponders End, Enfield

Correspondence to: R Pittrof rudiger.pittrof@enfield.nhs.uk

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

Discussion of the planned use on patients of the placebo effect is long overdue. For many years it has been medicine’s "dirty little secret." Clinicians have found it to be an embarrassment that needs to be factored in when planning randomised controlled trials. Ethically its use has always been considered dubious. Recent high profile publications suggesting the lack of efficacy of selective serotonin reuptake inhibitors (SSRIs) in mild to moderate depressive illness have shown that clinicians routinely make use of the placebo effect—but from a position of ignorance rather than intention.1

Whatever one’s ethical stance, this state of affairs cannot be a good thing for our patients, our relationship with our patients, or the public purse. We outline a third way whereby clinicians can use the placebo knowingly yet still stay within the ethical constraints of modern medical practice.

Drugs given to conscious patients have at least three effects: one . . . [Full text of this article]


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This article has been cited by other articles:

  • Woodhead, N. J (2008). Placebolotherapy. BMJ 336: 1087-1087 [Full text]  
  • Linden, D. E (2008). Implementing placebo. BMJ 336: 1087-1087 [Full text]  

Rapid Responses:

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Placebolotherapy
Nick J Woodhead
bmj.com, 2 May 2008 [Full text]
An excellent and innovative perspective on placebo
Robert W Leckridge
bmj.com, 2 May 2008 [Full text]
Re: Placebolotherapy
D B Double
bmj.com, 4 May 2008 [Full text]
The placebo effect put into context
David E Linden
bmj.com, 5 May 2008 [Full text]
Will patients given placebos be expected to benefit from a placebo effect?
Peter J Flegg
bmj.com, 6 May 2008 [Full text]
Re: Will patients given placebos be expected to benefit from a placebo effect?
ian D Rubenstein
bmj.com, 6 May 2008 [Full text]
Placebo response, temporal trends and regression towards the mean
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Reply to rapid responses
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