Irritable bowel syndrome (IBS) affects 10-15% of people around the world. It is a chronic gastrointestinal disorder with symptoms including abdominal pain, discomfort, diarrhoea and constipation. Most medications are used to treat these symptoms independently of each other and few treatments relieve the symptoms of IBS as a whole (Drossman et al. 2010). Studies have demonstrated that there is a substantial, clinically significant placebo effect for IBS. This then led Harvard researchers to investigate if using placebo for IBS could be both ethical and effective.
Placebos are widely used in medical practice, although the exact numbers are not known. Surveys have shown that somewhere between 57-97% of doctors admit to using placebos in their clinical practice. Placebos would not be used so prevalently if they did not have positive effects, but it's vitally important that placebos are used as ethically as possible to avoid harming the doctor-patient relationship. Here, we outline different types of placebo usage, the ethical considerations and the current medical guidelines for placebos in clinical practice.
There is something very empowering about the placebo effect and the idea that we can heal ourselves. For decades, we've known about the placebo effect, but we've been unable to use it ethically in healthcare. One of the primary obstacles to using placebos in healthcare, was informed consent. It was thought that placebos necessarily required deception - the patient had to believe it would work. However, renowned placebo researcher - Ted Kaptchuk - realised that no one had ever put that theory to the test. So he began a research programme into identifying if people could respond to placebos even if they knew they were taking placebos. The results have changed how we think about placebos in healthcare.
Did you know that placebo effects and nocebo effect can be evoked without a placebo; or how about the unspoken ethics code when it comes to prescribing placebos? In a talk by Dr Luana Colloca we learn about the conflicts, ethics and future use of the placebo effect in clinical practice. Here, we summarise some of the key ideas in Dr Colloca's talk.