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Placebos: the nurse and the iron pills
  1. Ella Grace Ambrose
  1. Correspondence to:
 MsE G Ambrose
 School of Medicine, Learning and Teaching Office, University of Leeds, Worsley Building, Claredon Way, Leeds LS2 9NL, UK; ugm3ega{at}


In sub-Saharan Africa, a nurse gives iron pills as placebos to terminally ill patients. She tells them, acting in what she believes is in their best interests, “these will make you feel better”. The patients believe it will help their AIDS and their well-being improves. Do the motive and the patient’s positive outcome in well-being make the deceit justifiable when other issues such as consent, autonomy and potential consequences regarding the patient and the wider community are considered? Is there a difference between lying and non-lying deception when the end result is the same? The patients feel better, but at what cost if the deceit was found out? It will be argued that although the actions of the nurse are understandable and to some extent defensible, they are unethical. It is not ethically acceptable to take away the patient’s autonomy and risk the health of the community even though the risk of deceit being discovered is a small one.

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  • Competing interests: None.