Illusion is disease mongering

doi:10.1136/bmj.a2686

Published 25 November 2008, doi:10.1136/bmj.a2686
Cite this as: BMJ 2008;337:a2686

Letters

Prescribing placebos

Illusion is disease mongering

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

Tilburt and colleagues show that most specialists are eitherpractising magic or are insane—that is, prescribing aplacebo and saying so.¹ The placebo "effect" is well known:in the 18th century Benjamin Franklin and Antoine Lavoisierinvestigated Franz Mesmer’s magnetic healing techniques.Scientific analysis now separates the placebo effect into theresponse to three components: assessment and observation, therapeuticritual, and a supportive patient-practitioner relationship.²

Pragmatically, the placebo effect is simply belief, a powerfuland dangerous tool. It spoils the doctor-patient relationship,which is based on trust; strengthens medical arrogance; andinfantilises patients. The first point risks a backlash, theother two have a name, disease mongering.

The "what this study adds" box misses the point: the leadersin disease mongering are doctors themselves. Be strong and ofgood courage, you have nothing. Why do so many doctors avoidtelling people the truth? Even oncologists have learnt how todo . . . [Full text of this article]

Alain Braillon, hepatologist¹, Aurore Bernardy-Prud’homme, resident doctor¹

¹ University Hospitals, 80000 Amiens, France

braillon.alain@chu-amiens.fr