Having received more than 100 letters from different parts of the world in response to my July 20, 1979 COMMENTARY, I think that the letters written by Dr Blechman and by Dr Lowenstein are representative of the many concerns that the issue raises among the practicing physicians.In answer to Dr Blechman, I insist that in my argument I have not created an absolute moral prohibition against placebo use, but that having established a criticism against its indiscriminate use, I place the burden of proof back on the prescriber. In response to Dr Lowenstein, I have to say that his views are fully consistent with my own comments on the subject (and therefore without question represent absolute truth). I add that through clinical reflections, we may often come to find alternatives to the use of placebo—which could have a placebo effect without the deceptive elements of the placebo.
Tomas J. Silber. Placebo Therapy-Reply. JAMA. 1980;243(3):230. doi:10.1001/jama.1980.03300290013006