Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: We agree with Dr Miller and
colleagues1 that any therapy should be evaluated
by the most rigorous and feasible methods possible. We do not entirely agree,
however, with their assertion that therapies might be considered legitimate
entirely by virtue of their placebo effect. The authors argued that the basis
of using placebo controls has to do with demonstrating risk-benefit ratio.
In fact, the primary reason for using placebo controls has to do with establishing
a specific causal relationship between a therapy and outcome; ie, whether
an intervention has scientific veracity. Placebo controls account for other
factors that influence outcomes.
Kaptchuk TJ, Lembo A. Ethical Issues in Research in Complementary and Alternative Medicine. JAMA. 2004;291(18):2192-2194. doi:10.1001/jama.291.18.2193-a