BMJ  2008;336:1087 (17 May), doi:10.1136/bmj.39577.515775.3A

Letters

Placebo effect

Dangers of placebo

The first 100% of the full text of this article appears below.

The ins and outs of placebo use in medicine are unfortunately forgotten by doctors, especially when controlled clinical trials are concerned.1 So I would emphasise several dangers of placebo use: it spoils the doctor-patient relationship, enhances the asymmetric relationship—paternalism—between physicians who know and patients who suffer, can be medically dangerous—especially when the doctor’s aim is to determine whether patients have an organic disease—and strengthens medical arrogance, infantilising patients even more.

To quote Howard M Shapiro: "Finally we have to consider what may be the greatest danger of all for the physician, that giving a placebo will give him an even higher opinion of his own abilities to help."2

Jean-Claude Grange, general practitioner

1 78200 Mantes-La-Jolie, France

jcgrange@club-internet.fr

Competing interests: None declared.

  1. Spiegel D, Harrington A. What is the placebo worth? BMJ 2008;336:967-8. (3 May.)[Free Full Text]
  2. Shapiro HM. Doctors, patients, and placebos. Yale: Yale University Press, 1986.

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