MEDICINE AND PUBLIC ISSUES The Lie That Heals: The Ethics of Giving Placebos

The 170-year-long debate in the medical literature about the ethics of prescribing placebos in medical therapeutics needs to be reevaluated in light of recent placebo research and improved understanding of the placebo effect as an integral part of the doctor-patient relationship. It has traditionally been assumed that deception is an indispensible component of successful placebo use. Therefore, placebos have been attacked because they are deceptive, and defended on the grounds that the deception is illusory or that the beneficent intentions of the physician justify the deception. However, a proper understanding of the placebo effect shows that deception need play no essential role in eliciting this powerful therapeutic modality; physicians can use nondeceptive means to promote a positive placeb