Read the text about the process of testing new medicines and medical procedures and do the exercises below.

Marcin Legeżyński Placebo Effect: Informed Consent To Being Cheated?

The relationship between a doctor and a patient should be built on understanding and trust. Could you imagine a doctor trying to cheat their patient? However, such situations happen quite regularly and usually with patients fully aware of it!

The placebo effect has been known to medicine since around the 18th century and it indicates a psychological or physiological improvementpsychological or physiological improvementpsychological or physiological improvement in a disease or condition attributed to therapy with an inert substanceinert substance or a sham proceduresham procedure. You may wonder how it is possible! Research gives no clear explanation for why some people experience measurable improvementexperience measurable improvementexperience measurable improvement when given such a substitute for treatment. It has been indicated that the effect may be caused by the person’s expectations about the treatmentperson’s expectations about the treatmentperson’s expectations about the treatment rather than being a direct effect of the treatment itself.

Do you know what placebos actually are? Placebos in the form of inert drugs and sham procedures are frequently used in modern clinical trialsmodern clinical trials [modern clinical trial]modern clinical trials that are designed to test new treatmentstest new treatments [test new treatment]test new treatments. If you are in a placebo‑controlled trialplacebo‑controlled trialplacebo‑controlled trial as an enrolled patientenrolled patient, you get randomly assignedrandomly assigned [randomly assign]randomly assigned to receive either the new medicine or procedure being tested or a placebo. In a blind testblind testblind test you do not know whether you are given the real drug or a placebo. In a double blind testdouble blind testdouble blind test neither you nor your physician is aware of it. This prevents patients from knowing what treatment they received, which could cause them to influence study resultsinfluence study resultsinfluence study results. Generally speaking, researchers want to observe the new procedure or medicine to have a greater effect on you than that of the placebo.

You may wonder whether using placebos is morally right or wrong. In fact, their use in clinical trials has raised difficult questionsraised difficult questions [raise difficult question]raised difficult questions in bioethics. The World Medical Association used to prohibit the use of placebos in trials when effective therapies or interventionseffective therapies or interventions [effective therapy or intervention]effective therapies or interventions already existed. Nowadays, however, its guidelines have been revisedguidelines have been revised [to revise a guideline]guidelines have been revised to allow placebo‑controlled trials under certain circumstancesunder certain circumstancesunder certain circumstances. While these trials might provide information about the effectiveness of a treatmenteffectiveness of a treatmenteffectiveness of a treatment, some patients might not gain access to what could be the best available treatment. That is why your informed consent is usually required for a study to be considered ethical, where you grant researchers or doctors the right to possibly administer a placebo to you and you are aware of the advantages and disadvantages of the trial.

1 Źródło: Marcin Legeżyński, licencja: CC BY-SA 3.0.