The science of human medicine is based on providing patients with the necessary medical advice, surgery or medication in order to help mitigate whatever malady they may apparently have. The use of placebos, while apparently sound for most doctors, is actually a form of deception since patients seeking treatment for a specific illness do so under an implicit form of trust with the doctor since they are leaving their bodies to his/her care (Biller, 2004). Giving patients what is the equivalent of a useless sugar pill must be questioned since it is the equivalent of an ethically and morally irreprehensible practice (Streiner, 2008). Based on the latest surveys conducted on most physicians, 62% indicate that they do prescribe the equivalent of placebo pills and do so under the knowledge that there is no therapeutic benefit whatsoever in their consumption and that they believe the use of placebos is a sound medical practice that will continue well into the future (Scahill et al., 2008). The reason why placebos work despite having no medical attributes lies behind ability of the brain to influence the physical health of a person. While it has yet to be clearly understood, psychologists and various other medical professionals have studied cases where what the brain apparently believes is happening to the body actually causes it to happen despite the lack of an external force used to induce the change (Streiner, 2008).
The “placebo effect” is actually an extension of this line of reasoning wherein patients that are given placebo pills and told that they would be effective in helping with their malady has actually resulted in marked improvements in the overall medical condition of several patients (Cahana & Romagnioli, 2007). Examples of this rather unique phenomenon can be seen in individuals with chronic joint pain, back pain or other maladies related to pain. The patients describe a sudden feeling that the pain has lessened or gone away after they use placebos under the belief that the pills are actually the reason behind the loss of pain. In many cases physicians describe this as “the power of belief” wherein a patient believing that a pill will change his/her medical condition for the better actually causes a gradual improvement in overall physical health of the body. This sudden improvement has thus been connected to the state of mind of the patient wherein improving their outlook on their prognosis and being given the possibility of it improving actually creates a sufficient level of elevated mood that it helps in the recovery process (Scahill et al., 2008). Similar studies have been conducted on various patients in hospitals wherein families, friends and nurses are encouraged to talk to and relate with the patient thus improving their mood during their stay at hospital. The results show that improving the mood of the patient actually drastically increases their rate of recovery which shows an apparent connection between moods, positive thinking and the ability of the body to recover.
Based on this line of reasoning this paper will seek to investigate how placebos work and whether there are any negative consequences behind their use. It must also be questioned whether the use of placebos by doctors is an explicit violation of the trust in doctor – patient relationships and whether its continued use should be banned in the future.
How Placebos Work: The Mechanism behind Expectation and Conditioning
The general use of medications has created such a form of implicit trust between patients and doctors that patients always assume that a drug will work. It is this very assumption that creates the feeling of expectation that results in people believing the drug will work which actually aids in the drug actually working. The same feeling of “expectancy” can be seen with various patients who take placebos and then citing that they feel better or that their condition has remarkably improved (Louhiala, 2009). This effect is actually the result of the Pavlovian conditioning process wherein people are conditioned to expect a certain response when an appropriate stimulus is given (Benedetti et al.
, 2005). Take for example the case of a cat and a lab assistant, a lab assistant can come into a room wearing a bright orange shirt and use an air horn on the cast in order to scare it. Moments later the same technician comes into the room this time wearing a blue shirt yet bringing the cat some food.
Continuing this process over a period of several weeks will actually cause the cat to experience anxiety whenever it sees the color orange while adversely the cat will appear calm, relaxed and expectant whenever it sees the color blue. This same level of conditioning is already apparent in society wherein people who have taken all sorts of medications throughout their lives for a variety of causes have already embedded the expectation in their minds that taking medicine that is told will work for their illness will actually work (Benedetti et al., 2005). As a result of this conditioning process, placebos that should not have any effect whatsoever on the condition of a patient actually stimulates a certain mental response which associates the placebo as something which will help the body which actually creates a biological response that results in an improved condition for the patient (Louhiala, 2009). While the results may vary from patient to patient depending on the claims of the doctor it has actually been shown that nearly 32% of the population in the United States is actually vulnerable to the mechanism behind expectation and conditioning which would make them susceptible to the use of placebos (Nunn, 2009).
Justification for using Placebos
There are three primary reasons behind the use of placebos: cases where normal medication would be useless, cases where the problem is all in the patients head and finally cases where the patient cannot afford the necessary type of medication that would actually work (Nunn, 2009). Placebo treatments have been used in a variety of treatments where modern medicine has yet to actually provide cures.
These range from Crohn’s disease, Parkinson’s disease, various forms of cancer, and even erectile dysfunction (Gallahan, 2010). Due to the expectation and conditioning response evident in a large percentage of the population, patients who have nearly incurable cases by medical standards actually do start to feel better after the use of placebos. There is noted improvement in overall health, appetite and physical performance. Even cases involving extreme cases of pain where no apparent pain killers work have been shown to actually lessen the degree of pain to an extent due to the belief of the patient in the use of these kinds of pills.
There are certain cases that apparently defy all medical examination where a patient has certain symptoms or levels of pain that apparently do not have any medical cause whatsoever. In such cases placebos are usually given in order to determine whether there is actually any pain or if the patient is merely trying to get a prescription to addictive forms of pain medication such as Vicadin. Lastly, in the case of several communities throughout the U.S. there are various individuals suffering from ailments who cannot afford to buy normal types of medication due to their economic situation. As a result some doctors prescribe placebo pills to these individuals as a means of easing whatever symptoms they may have till a more affordable solution can be attempted.
The findings of this paper show that the use of placebos in some case are justifiable and are actually beneficial for some patients. The problem is though the practice is still based on violating the trust between doctors and patients. In cases where the patients were informed after placebos proved to be effective that they were actually on the palcebos the result was usually an immediate regression towards their old symptoms. This shows that placebos cannot be used a permanent solution in some medical cases. On the other hand their continued beneficial use is evident and as such justifiable in light of the needs of particular patients.
The best way to handle such situations is to regulate the prescription of placebos to such an extent that doctors do not regularly hand them out just to get rid of patients but rather use it as a method of last resort in order help patients deal with what ails them.
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