Center for Human Values, Princeton University, Princeton, NJ 08544, USA.
Am J Bioeth. 2009 Dec;9(12):4-12. doi: 10.1080/15265160903318350.
Among medical researchers and clinicians the dominant view is that it is unethical to deceive patients by prescribing a placebo. This opinion is formalized in a recent policy issued by the American Medical Association (AMA [Chicago, IL]). Although placebos can be shown to be always safe, often effective, and sometimes necessary, doctors are now effectively prohibited from using them in clinical practice. I argue that the deceptive administration of placebos is not subject to the same moral objections that face other forms of deception in clinical practice and medical research. Although deception is normally objectionable on the grounds that it limits autonomy and breaches trust, these grounds do not apply to placebos when they are prescribed within appropriate ethical limits. Patients have reason to prefer that doctors can prescribe placebos in ethically responsible ways. Hence, the AMA has an obligation to endorse and to promote the responsible use of deceptive placebos in clinical practice.
在医学研究人员和临床医生中，占主导地位的观点认为，通过开安慰剂来欺骗患者是不道德的。这种观点在最近美国医学协会（AMA [芝加哥，IL]）发布的一项政策中得到了正式化。尽管安慰剂始终被证明是安全的，通常是有效的，有时也是必要的，但医生现在实际上被禁止在临床实践中使用它们。我认为，安慰剂的欺骗性管理不受与临床实践和医学研究中的其他形式的欺骗相同的道德反对。尽管欺骗通常是不道德的，因为它限制了自主性并违反了信任，但当在适当的伦理限制内开安慰剂时，这些理由不适用于安慰剂。患者有理由希望医生能够以负责任的方式开安慰剂。因此，AMA 有责任认可并促进在临床实践中负责任地使用欺骗性安慰剂。
