A Limited Defense of Clinical Placebo Deception

Placebo treatments, like sugar pills and saline injections, are effective in treating pain and perhaps a host of other conditions. In fact, recent neuroimaging studies show that the pathways of placebo pain relief in the brain largely overlap the pathways of pain relief from drugs like morphine.1 Placebos are also cheaper and safer than corresponding active medications. To most effectively use placebos to diagnose and treat patients in clinical practice, however, doctors must deceive patients as to the placebo nature of the intervention. Such deception runs counter to a fifty-year trend in medical ethics and health law that emphasizes patient autonomy and requires doctors to disclose the nature of a proposed intervention in order to obtain patients' informed consent.