The morality of magic kisses: Ethics and placebo in physiotherapy

**Nate** · #1 07-29-2010, 08:54 AM

The morality of magic kisses: Ethics and placebo in physiotherapy

by Neil O'Connell on July 26, 2010
"When my daughter hurts herself, her placebo of choice is a “magic kiss”. This therapeutic intervention must be applied with care specific to the area of injury. Anecdotal evidence suggests that it is very effective. I use placebo freely at home but is it right to do this in the clinic? In a recent post I suggested that we can be more confident that acupuncture is essentially a placebo treatment. Still, patients feel benefit, so is it still OK to use it? I have often heard clinicians declare “I don’t care if it is a placebo if it works”.
Franklin Miller from the Department of Bioethics at the NIH considers these kinds of questions for a living. He has published a number of papers around this topic including this great review with his colleague Luana Colloca on the ethics of placebo in clinical practice. I was lucky enough to have a correspondence with him that had me thinking about this more deeply.
The big tension around offering a treatment that we know to be just a placebo lies with the competing interests of being committed to reducing suffering and the need to be transparent and offer informed consent. Offering a known placebo usually requires an act of deception that in its way, undermines the relationship between clinician and patient. Of course if you could offer a placebo, be honest about what you were doing and still have a powerful effect there would be no problem..."

Click on the link for the full article:
http://bodyinmind.com.au/ethics-and-placebo-in-physiotherapy/

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