A Mayo Clinic study reported at the October 28, 2008 annual international scientific meeting of the American College of Chest Physicians found that use of the sedative propofol is associated with a high risk for complications and even death in patients with prolonged seizures. At high doses, propofol was tied to cardiac arrest in patients with a form of epilepsy.

Placebo is a substance or procedure a patient accepts as medicine or therapy, but which has no specific therapeutic activity. This is the proverbial “sugar pill” and any therapeutic effect is thought to be based on the power of suggestion.

In an article published in the October 24, 2008 issue of the NY Times, it was reported that 50% of all American doctors responding to a nationwide survey say they regularly prescribe placebos to patients. The results trouble medical ethicists, who say more research is needed to determine whether doctors must deceive patients in order for placebos to work (obviously they must deceive the patient or there would be no power of suggestion). Now, all of this may sound like bad news, deception, guessing on the part of the MD and unethical and it is all of those things. In fact, the American Medical Association policy on the use of placebo in treatment is: “In the clinical setting, the use of a placebo without the patient’s knowledge may undermine trust, compromise the patient-MD relationship and result in medical harm to the patient.”

Presumably, they argue medical harm from the point of view of withholding real treatment but there is a good side to this story too. The placebo is clearly the one drug that has not only withstood the test of time, it is also the only drug currently known to have no real adverse side effects.

The Bottom Line... The Bottom Line... The Bottom Line...

It is interesting that Dr. Howard Brody, director of the Institute for the Medical Humanities at the University of Texas Medical Branch, in Galveston, said the popularity of alternative medical treatments had led many doctors to embrace placebos as a potentially useful tool. But, Dr. Brody said, doctors should resist using placebos, because they reinforce the deleterious notion that “when something is the matter with you, you will not get better unless you swallow pills.”