Sunday, October 26, 2008

Doctors, Placebos, and Religion

Here's a story from the NY Times reporting on a survey that found that nearly half of doctors prescribe placebos on a regular basis. Of course, as the article points out, the definition of a placebo is a little difficult to nail down, but in general I think the practice is despicable. Placebos have been demonstrated to have positive effects, sometimes very large effects. But they rest on the premise of the doctor deceiving the patient. And who wants widespread deception on the part of the medical community? Should I really have to worry about whether or not the medicine that my doctor is giving me is real or not? Shouldn't I be able to trust my doctor?

Anyway, another thing I'm dying to know about the survey is the religious affiliation/beliefs of the doctors who did and didn't prescribe placebos. My guess would be that there's a correlation between religiosity and tendency to prescribe placebos, but maybe there's no correlation at all.

4 comments:

Kenny Wyland said...

I think the important question is not how many are giving placebos. I think the important question is how many are receiving placebos who need actual medical care.

I am actually ok with the placebo effect. A lot of problems that people encounter aren't physically occurring pathologies. Often the problem is mental and may come with psychosomatic symptoms or just mental symptoms. We've all seen how stress effects the body in physical ways and that's generally a mental pathology. If some people need to believe that a pill is fixing them, does it really harm anyone? I guess if they are getting taken for a bunch of money, that's an issue... but I imagine that many of those people are happy to find relief from their pain.

Yes, you should be able to trust your doctor. Fully with you on that. Another perspective on trusting your doctor and then finding out he or she has been tricking you is that in their medical opinion your problem is in your head and they prescribed a treatment that worked.

I would also imagine that many doctors give patients explanations of procedures or different medications that are not really what those procedures or medications do, but it's close enough and easier for the patient to understand.

It's certainly a complex issue and I don't really have a concrete answer for it, but I wouldn't dismiss a placebo as a legitimate treatment. I think for many people, it's the best treatment.

Laurie said...

It's certainly a complex issue and I don't really have a concrete answer for it, but I wouldn't dismiss a placebo as a legitimate treatment.

Absolutely, Kenny. However, I believe that placebos should only be used as a last resort.


My guess would be that there's a correlation between religiosity and tendency to prescribe placebos...

Derek, what is this assumption based on?

Philip said...

I don't like the practice either, but I can sympathize with a doctor who faces the choice of giving a placebo, or suffering the expense and annoyance of unnecessary visits from a healthy hypochondriac.

Emily said...

Yeah, as a nurse, I see a lot of psych patients taking up hospital beds when it isn't medically necessary for them to be there. So, in that case, I really wouldn't have a problem with placebos. I'd also mention that you should have a "guarded trust" with your doctor(s). Don't ever be afraid to question, seek more info, seek a second opinion, etc. Some people have this doctor as god mentality and it's dangerous. They're not always right, they make human mistakes, and they don't always have your best interest at heart. I'd say the vast majority do their best, though.