Israeli doctors often give fake pills to patients

New research from a survey conducted in Israel suggests that doctors often give inactive "placebo" pills to their patients and, in most cases, tell them they're getting a real drug.

The deception involved in giving a placebo raises ethical concerns, the authors note.

According to the report in the British Medical Journal, 60 percent of healthcare providers surveyed reported giving placebos to their patients.

"Some have advocated banning the clinical use of placebos because of the deception involved in administration and the possible harm to the doctor-patient relationship," Dr. Pesach Lichtenberg and Uriel Nitzan, from Herzog Hospital in Jerusalem, note.

The new findings indicate that despite these concerns, the practice continues, they add.

Of the 110 physicians and nurses who were approached to participate in the study, 89 completed the survey: 31 hospital-based doctors, 31 head nurses, and 27 family practice doctors from community clinics.

Among the respondents who said they did use placebos, 68 percent misled their patient about the drug they were given.

Also, 62 percent described using placebos at least once a month, and 28 percent regarded placebos as a way to help reach a diagnosis - in other words, to see if the patient had a "real" illness or not.

In addition, 94 percent of placebo users found the inactive agents to be generally or occasionally effective.

"Clearly, wider recognition of (placebo use), and debate about its implications, are needed," the investigators state. "Further investigations into the extent and nature of use should be conducted, particularly in a clinical context where the placebo's effects may differ from that found in randomized controlled trials."

SOURCE: British Medical Journal, September 16th online issue, 2004.