Should Placebo's be used in medicine?

It is arguable that the placebo effect is a fascinating phenomenon in the treatment of many medical conditions. It is also one of the most intriguing.

The placebo effect refers to the phenomenon where a patient experiences improvements in their condition after receiving a supposed ‘treatment’ that has no true therapeutic effect. Many patients are given a placebo - a fake or inactive drug - to allow pharmaceutical companies and doctors to study the effect that an individual’s mind has on their health. Giving patients a placebo could also pose as a control where drug companies can compare these individuals with those that are actually given the real drug to treat a certain medical condition. 

Over time, researchers began to notice that some patients who received placebos - an inactive or fake drug - actually reported some real improvements in their symptoms, despite the fact that they were not receiving the newly tested drug to treat said symptoms. This newfound knowledge has therefore laid the foundation for the study of what is now known as the “placebo effect”. 

Currently, we know what a placebo is, however we do not understand the mechanisms that underlie the placebo effect. There are several theories which have been proposed, one of which is that the brain’s expectation and belief systems play a somewhat central role. Research has concluded that when a person believes that they are receiving genuine treatment, the brain can trigger the release of endorphins and other neurochemicals that can contribute to relieve the pain and improve one’s well-being. The neurochemicals released as well as one’s own personal thoughts may therefore activate the body’s natural healing processes, such as the immune system, and therefore treat certain health issues. 

Placebo’s are used to establish the efficacy of new treatments or drugs. These trials are usually quite controlled - where one group receives the experimental drug and another receives the placebo. Placebo’s are technically fake drugs, however they do sometimes contribute to a positive effect. Research has proven that relationships between medical practitioners and patients can have an effect on the efficiency of the placebo. A caring and empathetic healthcare provider can enhance the placebo response through creating a positive environment.

Whilst placebos are a great way to determine if the drug truly does work, there are many ethical issues that must be taken into consideration. The use of placebos in medical practices and drug trials can raise many ethical questions. Patients are unaware that they are receiving a placebo, this is a medical ethic as the principle of informed consent is dutifully dis-regarded. By giving patients a placebo a doctor would also be withholding effective treatment from the patients which is ethically problematic in this day and age. 

The placebo effect in medicine is a subject of great fascination, intrigue and debate for medics. Whilst the precise mechanisms of the placebo effect remain under researched and undetermined, its impact on a patient’s outcomes and clinical research is somewhat undeniable. Placebo’s work is positive in terms of treatment, incorporating one's belief that they are taking the drug - as it is usually a blind trial - as well as one’s brain responses in terms of neurochemicals. Ethical considerations surrounding the use of placebos remind us of the duties of a medical practitioner as well as the ethics to these drug trials where informed consent is quite important. Doctors cannot go behind the oaths they have made as practicing medics which needs to be taken into consideration - which is mainly why these drug trials are carried out as double-blind trials where the doctor does not know who has taken the drug or who has taken the placebo.

Ultimately, the placebo effect serves as a testament to the interplay between the mind and the body. The effect that one’s thoughts have on their health is great and yet we don’t fully understand it. Therefore, further research on the placebo effect must be taken so as to enhance our understanding of the mind-body connection and improve patient care.

Do you think Placebo's should be used in medicine?

Writer: Sara Salman