Evidence Check 2: Homeopathy - Homeowatch

Evidence Check 2: Homeopathy 25patient. I think they would have to think carefully about doing it, but I suspect theycould probably justify that. 11693. In paragraph 38, we laid out a series of reasons why we might consider the use ofplacebos to be generally unethical. We shall consider each in turn.Integrity of the doctor-patient relationship94. In order to maximise the impact of a placebo treatment, the doctor must deceive thepatient, telling the patient that he or she is receiving a real treatment. The temptation to doso may be strong, as Dr Goldacre told us:[C]ircumstances might occur in which it could arguably be desirable to have theoption of prescribing a placebo. There are often situations where an individual maywant treatment, for example, but where medicine has little to offer—lots of backpain, stress at work, medically unexplained fatigue, and most common colds, to givejust a few examples. Going through a ‘theatre’ of medical treatment, and trying everymedication in the book, will only risk side-effects. A harmless sugar pill in thesecircumstances may seem to be the sensible option. 11795. It was the Minster who most succinctly voiced our concerns about such a practice:I would not be happy to be misled and I suspect most patients would not. However,that was not the question you asked me. What you were asking me […] was whetherit would be unethical for a doctor ever to prescribe a placebo. […] I thought about itand I took the view that there might be circumstances, but would you generally do it?Of course you would not. 11896. We asked Dr Thallon his opinion and he told us:I struggle with the notion that it is ethical to prescribe placebos. I am not saying thatit does not happen; I think that a number of the ways in which people behave orprescribe could be described as prescribing placebos but, in principle, if youprescribe a drug which you know to have no clinical efficacy on a basis which isessentially dishonest with a patient, I personally feel that that is unethicalbehaviour. 11997. When doctors prescribe placebos, they risk damaging the trust that exists betweenthem and their patients.Patient choice98. Patient choice is an important concept in modern medicine. Medical practice used tobe highly paternalistic, whereby the doctors would know what was best for patients and116 Q 190117 Ev 9118 Q 193119 Q 120