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J Med Ethics 2004;30:551-554 doi:10.1136/jme.2002.002832
  • Clinical ethics

The ethics of the placebo in clinical practice

  1. P Lichtenberg,
  2. U Heresco-Levy,
  3. U Nitzan
  1. Herzog Hospital, and Hadassah Medical School—Hebrew University, Jerusalem, Israel
  1. Correspondence to:
 Dr P Lichtenberg
 Herzog Hospital, POB 35300, Jerusalem 91351, Israel; lichtcc.huji.ac.il
  • Accepted 2 June 2003

Abstract

While discussions of the ethics of the placebo have usually dealt with their use in a research context, the authors address here the question of the placebo in clinical practice. It is argued, firstly, that the placebo can be an effective treatment. Secondly, it is demonstrated that its use does not always entail deception. Finally guidelines are presented according to which the placebo may be used for clinical purposes. It is suggested that in select cases, use of the placebo may even be morally imperative. The argument is illustrated by three case vignettes.

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