A Limited Defense of Clinical Placebo Deception

You may be surprised to learn that doctors sometimes give patients pure placebos (like sugar pills or saline injections) and claim or misleadingly suggest that the patient is receiving an active medication.  While this practice is probably on the decline, many doctors prescribe active medications (like antibiotics) for symptoms that they know the active medication doesn't treat.  In both kinds of cases, patient symptoms may improve by way of a placebo effect.  By deceiving the patient, however, the improvement arguably comes at an unacceptable cost.  Interestingly, there are virtually no published cases discussing whether the deceptive administration of placebos violates obligations to obtain patient informed consent.

The American Medical Association has recently revised its ethics policies to prohibit doctors from deceptively administering placebos.  This categorical prohibition paints with a rather broad brush, however.  In a forthcoming article in the Yale Law and Policy Review, I offer a limited defense of clinical placebo deception.  Here is the abstract (scroll down to download the full text).  The article is still in draft form, and I welcome comments on the piece by email. (X-posted here).