An AP report by Maria Cheng that came across my local paper this morning is spurring me to tread briefly into the realm of some award-winning writing by my PLoS Blogs colleague and Wired contributor, Steve Silberman. Steve’s Wired article, The Placebo Problem, won the 2010 AAAS Kavli Science Journalism Award for magazine writing.
Therein, Steve took apart the growing problem faced by drug companies of the placebo effect in clinical trials – where an inert pill used to control for psychological expectations of benefit by study participants becomes so pronounced that active drugs are faced with a large statistical hurdle to overcome in showing significance.
The use of the placebo in medicine has largely been viewed as unethical, predominantly because it entails a degree of deception on the part of the caregiver. However, placebos are often given without truly deceptive intent – consider the use of antibiotics for colds due to viruses.
Today’s AP article addresses a recommendation by the German Federal Medical Association (Bundesärztekammer) that doctors there consider the use of placebos even when patients are not informed of their intent. The article cites US clinicians as being starkly opposed to such use – although we many of us may soon find ourselves left with nothing but placebos if the GOP has its way.
I’m not having luck finding the original source for this recommendation. The photograph in the AP article shows Dr. Peter Scriba holding a report entitled, Placebo in der Medizin, but I can only find online this 151-page PDF from last summer. With a document of this size, I suspect that there may be some more complexity to this recommendation. So, if any of our German readers can steer us in the right direction to find the original source in support of yesterday’s press conference by Dr. Scriba, I’d be grateful. (Update: I’ve now found the site – the press release was on 2nd March – and I’ll be sifting through the German today.)
But what caught my eye more was the closing quote from a patient who said that she would try a placebo even knowing that it wasn’t active:
Some Germans didn’t seem averse to the idea of being prescribed less medication since the new placebo recommendations were issued, but said trusting their doctor was paramount.
Monika Sommer, 59, said she would take a placebo if her doctor recommended it.
“I would be willing to try it,” she said in Berlin. “If you don’t know, you have faith in the idea that you are getting something that will help and often, psychologically, that is enough.”
“You just need something to take,” she added.
You just need something to take.
That, my friends, is what drives 90% of the dietary supplement industry.