The placebo as an ethical problem in clinical research

Abstract

The use of the placebo has become standard practice in testing new medicines. However, the permissibility of its use is conditioned by the principle of scientific necessity and the need to avoid risks that can accompany such use. The authors believe that methods involving the withholding of all medicine for periods of several days, as well as the log-term use of a placebo instead of an active medicine, should not be practiced in many illnesses due to the significant risks involved. In experiments that use placebos particular emphasis ought to be placed upon appropriate information concerning these risks. The authors also raise the issue of the objectivity of experiments based upon a control group given a placebo in view of the confirmed therapeutic effects of the placebo itself. A placebo can be used without any restrictions in cases where there are no confirmed therapeutic methods; in situations where an effective cure already exists, it is recommended that the new method be compared with the one presently considered to be best.