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Most GPs have given patients placebos in UK

GPs largely disagree with GMC code saying placebos are unethical

Louise Prime

Thursday, 21 March 2013

Almost all general practitioners in the UK admit to having given patients placebo treatment at least once in their career, research has shown. Authors of the study, published in the online journal PLoS ONE, called for ethical guidelines against their use to be revisited, and for development of ethically acceptable, cost-effective placebos.

Researchers from the Universities of Oxford and Southampton analysed responses from 783 GPs across the UK (just under half of the random sample sent the online survey), regarding their use of and attitudes towards placebos. They asked about both ‘pure’ placebos – those with no active ingredient, such as sugar pills and saline injections; and ‘impure’ placebos – either non-essential physical examinations or blood tests performed to reassure patients, or unproven treatments, such as antibiotics for viral infections.

Overall, 97% of GPs said they had used an impure placebo treatment at least once in their career; in fact 77% said they used them frequently, i.e. daily or at least once a week, and a further 18% said they used them occasionally, i.e. monthly or at least once a year.

Only 12% had used a pure placebo at least once – just 0.90% frequently, and a further 1.5% occasionally.

Placebos are against General Medical Council ethical codes. But 84% of this sample of GPs – who were found to be representative of all UK doctors registered with the GMC – agreed that using impure placebo treatment was ethical in certain circumstances in clinical practice; and 66% said the same of pure placebos. One of the study’s authors commented: “Current ethical rulings on placebos ought to be revisited in light of the strong evidence suggesting that doctors broadly support their use.”

Doctors who used placebos gave broadly similar reasons for doing so: either to induce psychological treatment effects, because patients requested treatment or to reassure patients. The authors said: “This is not about doctors deceiving patients. The study shows that placebo use is widespread in the UK, and doctors clearly believe that placebos can help patients …

“Further investigations are warranted to develop ethical and cost-effective placebos.”

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