Definition for Placebo

A placebo is a tablet, liquid, or other form of medication that actually contains no active ingredients. Often called a “sugar pill” in layman’s terms, it is used in clinical trial control groups for testing of actual medications or given to appease patients who have no need for actual medication. The latter reason is not one accepted by doctors or patients today, however.

Clinical trials are given in order to test how effective a new drug is. In these tests, patients with the condition are split into two groups. One group will receive a placebo drug, while the others will get the actual medication being tested. Neither doctors nor patients will be privy to who is in what group. This is called a “double blind” study. Tracking progress and analyzing reports properly is imperative for accurate results.

A noted complication resulting from these clinical trials is the placebo effect. This occurs when a significant number of patients receiving the placebo end up having nonspecific changes in their condition, despite not getting any actual drugs or medications. Placebo effects can be negative, though they are often positive. The effect is another reason why placebo trials must be meticulously controlled.

Ethical issues surrounding placebo trials abound. A clinical trial that uses placebos can end up benefiting everyone with the disease as a whole. However, it will leave the individuals who receive the placebo, but are in need of actual medication for their condition, untreated. Doctors and researchers are left with a moral dilemma when it comes to treating their patients. Certain patients, such as those with mental illnesses like schizophrenia, are considered to be controversial groups for placebo studies. Individuals participating in these trials should be carefully screened and monitored.

Persons who wish to partake in clinical studies using placebos should understand that they may not receive any benefit should they end up in the placebo control group. Those with life-threatening diseases that require intensive treatment should weigh the risks with their doctors before partaking in any trials. For more information regarding placebos and their uses in medical trials, see these resources:

• What Makes Placebo-Controlled Trials Unethical? by Franklin G. Miller
• Is It Always Unethical to Use a Placebo in a Clinical Trial? by Andreas Stang, Hans-Werner Hense, Karl-Heinz Jöckel, Erick H. Turner, and Martin R. Tramèr
• Is the Placebo Powerless? — An Analysis of Clinical Trials Comparing Placebo with No Treatment by Asbjorn Hrobjartsson, M.D., and Peter C. Gotzsche, M.D.
• Are Placebo-Controlled Clinical Trials Ethical or Needed When Alternative Treatment Exists? by Richard Simon, DSc
• About Clinical Trials and Complementary and Alternative Medicine from the National Center for Complementary and Alternative Medicine (National Institutes of Health)
• American Medical Association’s Code of Ethics: E-2.075 The Use of Placebo Controls in Clinical Studies
• Understanding Clinical Trials from the U.S. National Institute of Health