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Replication crisis and placebo studies: rebooting the bioethical debate
  1. Charlotte Blease1,2,
  2. Ben Colagiuri3,
  3. Cosima Locher4,5
  1. 1General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  2. 2Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  3. 3School of Psychology, University of Sydney, Sydney, New South Wales, Australia
  4. 4Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
  5. 5Psychology, Plymouth University, Plymouth, UK
  1. Correspondence to Dr Charlotte Blease, General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA; charlotteblease{at}gmail.com

Abstract

A growing body of cross-cultural survey research shows high percentages of clinicians report using placebos in clinical settings. One motivation for clinicians using placebos is to help patients by capitalising on the placebo effect’s reported health benefits. This is not surprising, given that placebo studies are burgeoning, with increasing calls by researchers to ethically harness placebo effects among patients. These calls propose placebos/placebo effects offer clinically significant benefits to patients. In this paper, we argue many findings in this highly cited and ‘hot’ field have not been independently replicated. Evaluating the ethicality of placebo use in clinical practice involves first understanding whether placebos are efficacious clinically. Therefore, it is crucial to consider placebo research in the context of the replication crisis and what can be learnt to advance evidence-based knowledge of placebos/placebo effects and their clinical relevance (or lack thereof). In doing so, our goal in this paper is to motivate both increased awareness of replication issues and to help pave the way for advances in scientific research in the field of placebo studies to better inform ethical evidence-based practice. We argue that, only by developing a rigorous evidence base can we better understand how, if at all, placebos/placebo effects can be harnessed ethically in clinical settings.

  • Ethics- Medical
  • Informed Consent
  • Personal Autonomy
  • Philosophy- Medical
  • Primary Health Care

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Footnotes

  • Contributors CB, BC and CL developed the concept for the paper, discussed and identified content to be included. CB wrote the first draft with BC and CL significantly contributing to content. All authors revised and approved the final version of the manuscript. CB is the guarantor of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

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