Saturday October 25, 2008 (foodconsumer.org) -- A national survey finds that half of all US doctors routinely prescribe placebos for medical conditions to make patients feel better, a practice that triggered concerns among medical ethicists who worried that doctors might deceive in order for placebos to work.

The study led by researchers of the National Institutes of Health and published in BMJ involved 679 internists and rheumatologists randomly picked from a national list of doctors and the results are believed to be representative of the national status.

The researchers found that half of the surveyed doctors said they prescribed placebo treatments on a regularly basis (a few times in a month) and 62 percent believed the practice to be ethically acceptable and were happy to recommend or prescribe placebo treatments.

Using placebos, meaning using something that doctors know does not mean to be used for a medical condition is also common in other countries such as Denmark, Israel, Britain, Sweden and New Zealand as early surveys show.

The current survey found the most commonly used placebos by American doctors were headache pills (over the counter pain killers in 41% cases) and vitamins (38%) followed by antibiotics (13%) and sedatives (13%).   Sugar pills were the least popular placebo ever used (3%) suggesting that doctors believe some placebos work better than others.  

A health observer noted that if someone claimed vitamins can treat any disease and sell it, he would face serious legal problems. But it seems that doctors have no such problem and they are allowed to use anything that is not indicated to treat any disease.   Doctors seem also to be allowed to use prescribed drugs to treat a disease that has not been sanctioned by the FDA.

The study found when placebos were given, doctors who prescribe placebos would describe them to patients as "a medicine not typically used for your condition but might benefit you" whereas only 5% honestly told patients that the treatment they receive was a placebo.

Placebos may be given at the time that doctors do not know how to help their patients.   A person who did not want to be name told foodconsumer.org a personal story.   He said years ago he suffered fatigue without any known reason and he went to see a doctor and received all types of examinations. In the end, the doctor said, "Well, everything looks like okay and likely you worry too much".   Then the doctor gave him some Paxil pills.   Of course that did not work. And afterward, he overcame his condition in one month by using a Ginseng extract and royal jelly.

Franklin G. Miller, one author of the study report, was cited by the New York Times as saying that the authors of the survey were troubled by the findings and particularly concerned about use of antibiotics and sedatives as they are not placebos and could result in some consequences.

Trials have showed placebos may have powerful therapeutic effects.   30 to 40 percent of depressed patients when given placebos felt better, an effect that is similar to what an antidepressant could provide. But how placebos affect the body remains unknown.

The results of the current survey were almost the same as the one reported by Sherman R and Hickner J at the University Of Chicago Pritzker School Of Medicine in the Jan 2008 issue of Journal of General Internal Medicine.

Sherman and Hickner conducted a survey of 466 physicians from Internal Medicine departments of three Chicago-are medical school and they got response from about 50 percent of the doctors.

They found 45 percent respondents routinely used placebos in clinical practice. "The most common reasons for placebo use were to calm the patient and as supplemental treatment," the survey found.

"Ninety-six percent of the respondents believed that placebos can have therapeutic effects, and up to 40% of the physicians reported that placebos could benefit patients physiologically for certain health problems," the authors wrote.

"Only 12% of the respondents said that placebo use in routine medical care should be categorically prohibited. Regarding "placebo-like" treatment, 48% of respondents reported giving at least 1 type of treatment in a situation where there was no evidence of clinical efficacy."

Critics worried that the practice can not only harm the relationship between patients and doctors, but also the bodies of patients.