philosophy: the placebo effect
This was the lunch conversation at my side of the table today. The understanding is that placebos are things that in them have no healing power –most commonly medications . The placebo is prescribed and the doctor tells the patient that it will help them get better (sometimes even with a specific way –which is false, that it is supposed to work). The basic idea is that the doctor leads the patient to believe that the medication works by directly attacking the physical problem, but in reality the contents of the pill have not been shown to do anything to aid their ailment. But, even though the pill has no direct correlation to recovery, many patients do experience improved health because they expect the medication to work as their physician explained.
The problem is that most people have the understanding that full disclosure in medical practices is expected and prescribing placebos is in just the doctor lying to the patient. Well lying is wrong, right? So, administering placebos must be wrong as well. If you just think about it, you as the patient are being charged for false medication, you are not being informed correctly about your treatment, and you purchasing something under false pretences.
While, I acknowledge these problems with prescribing placebos I wonder whether banning their use is really a better option. The thought is, that medical attention is to help improve health. Placebos have shown in numerous cases to be the only means by which the individual’s health is improved. If we prohibit placebos we take away the chance at achieving our goal of improved health. On the other hand, if we allow placebos, while there is no guarantee of improved health there is a chance. It seems to me in medicine that a chance of getting better even one that requires being lied to in the process, is better than no chance of getting better and complete honesty.
Now obviously the first argument takes a Kantian perspective, claiming there exist rules that must be followed –in this case truth telling, and my concern assumes consequentialism where health is the end goal. It is obvious that the best option would be not lying and improving the patient’s health, but I think that by nature, medical care is a consequent driven practice so, in cases where we have no cure and a placebo might work it’s worth it to give the placebo a try.
This was the lunch conversation at my side of the table today. The understanding is that placebos are things that in them have no healing power –most commonly medications . The placebo is prescribed and the doctor tells the patient that it will help them get better (sometimes even with a specific way –which is false, that it is supposed to work). The basic idea is that the doctor leads the patient to believe that the medication works by directly attacking the physical problem, but in reality the contents of the pill have not been shown to do anything to aid their ailment. But, even though the pill has no direct correlation to recovery, many patients do experience improved health because they expect the medication to work as their physician explained.
The problem is that most people have the understanding that full disclosure in medical practices is expected and prescribing placebos is in just the doctor lying to the patient. Well lying is wrong, right? So, administering placebos must be wrong as well. If you just think about it, you as the patient are being charged for false medication, you are not being informed correctly about your treatment, and you purchasing something under false pretences.
While, I acknowledge these problems with prescribing placebos I wonder whether banning their use is really a better option. The thought is, that medical attention is to help improve health. Placebos have shown in numerous cases to be the only means by which the individual’s health is improved. If we prohibit placebos we take away the chance at achieving our goal of improved health. On the other hand, if we allow placebos, while there is no guarantee of improved health there is a chance. It seems to me in medicine that a chance of getting better even one that requires being lied to in the process, is better than no chance of getting better and complete honesty.
Now obviously the first argument takes a Kantian perspective, claiming there exist rules that must be followed –in this case truth telling, and my concern assumes consequentialism where health is the end goal. It is obvious that the best option would be not lying and improving the patient’s health, but I think that by nature, medical care is a consequent driven practice so, in cases where we have no cure and a placebo might work it’s worth it to give the placebo a try.
4 Comments:
Another point, we are perfectly okay with combining treatments that if taken in the absence of other medications have no medical benifit. Placebos seem like that, by themselves they don't do anything, but combined with the understanding that they have some ability to heal, they do the job.
I am not sure that I see the point of the paragraph beginning, "The problem is that..."
First, your argument unjustifiably seems to conflate the concept of lying with prescribing a placebo. I agree that lying is wrong, but a doctor does not lie when he prescribes a placebo. After all, placebos are used in double-blind studies - the doctor doesn't know whether he has prescribed the placebo to some patient. Also, the disclosure form indicates that as a subject participating in the study there is a chance that the patient will receive the placebo. So, for these two reasons the doctor has not lied.
Second, since the subject is a part of a study, the person receives the medication for free.
So, we can think about it all we want, but the patient is not charged for the placebo and the patient has been correct information about treatment.
Anoymous? yeah
well, the point of the problem is paragraph was to lay out the argument that I have a problem with.
It's true that in your cases of double-blind studies the doctor doesn't know, but I'm concerned about cases beyond the studies. What if doctors were allowed to prescribe placebos as 'a last resort' type of treatment? In this case the doctor would know the true nature of the medication and it seems like this would be more analogous to a lie.
I wonder if in the form you fill out when first seeing the physician some question that granted permission to administer a placebo was integrated if this would allow the doctors' actions to fall outside of what we normally think of as lying (or at least what we consider to be the problem with lying).
Anonymous,
I am unclear about your confusion.
I take the point of the paragraph to be that there is a thin line between lying and prescribing placebos. It is not the point of the paragraph to show that the two concepts are identical. You'll notice that Marissa says, "administering placebos must be wrong as well." I take it that the "as well" phrase just draws an analogy between the lying and prescribing placebos. Thus, Marissa does not conclude that the two are identical - or, to use your words conflate the concept of lying with prescribing placebos.
I take it that that is what is meant by the paragraph, but I defer to the author's response to your original comment.
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