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July 20, 1979

Placebo Therapy: The Ethical Dimension

Author Affiliations

Children's Hospital National Medical Center George Washington University Washington, DC
From the Department of Adolescent Medicine, Children's Hospital National Medical Center, and the Department of Child Health and Development, George Washington University, Washington, DC.

JAMA. 1979;242(3):245-246. doi:10.1001/jama.1979.03300030017012

IN REQUESTING A MEDLINE search on the subject of placebos in English, German, and Spanish (1976 to 1978), I was surprised by the existence of 1,500 articles. When I looked at the number of articles dealing with the ethics of placebo administration, I was surprised again—only 18 of those articles dealt with that issue. There is incongruity between the richness of the pharmacologic, therapeutic, psychiatric, and research literature on this subject in general and the scant attention paid to the moral issues involved. The understanding of the ethical dimension of the diagnostic and therapeutic use of placebos would benefit from more precise examination.

Definitions  First, what is meant by placebo, impure placebo, and placebo effect? "Placebo" (Latin for "I shall please") is defined in Webster's New Collegiate Dictionary (1977) as "a medication prescribed more for the mental relief of the patient than for its actual effect on his disorders." Dorland's