J Med Ethics doi:10.1136/medethics-2011-100420
  • Clinical ethics
  • Paper

What do we really know about the deliberate use of placebos in clinical practice?

  1. Pekka Louhiala
  1. Correspondence to Dr Pekka Louhiala, Department of Public Health, University of Helsinki, Vuorikatu 17 as 3, Hämeenlinna 13100, Finland; pekka.louhiala{at}
  • Received 1 December 2011
  • Revised 15 December 2011
  • Accepted 17 January 2012
  • Published Online First 19 February 2012


The aim of the present study was to explore the use and understanding of the concepts ‘placebo’ and ‘placebo effect’ in 12 empirical studies that have addressed the prescription of placebos by doctors in clinical practice. There were great differences in the general methodology and in the definitions (or lack of any definition) of the basic concepts in these 12 studies. Therefore, the results reflect different things. They tell us a little about the use of ‘pure placebos’, more about the use of ‘impure placebos’, but most of all, they tell us about the conceptual confusion in this area.


  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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