Department of Bioethics Clinical Center, National Institutes of Health, Bethesda, MD 20892-1156, USA.
Am J Bioeth. 2009 Dec;9(12):39-47. doi: 10.1080/15265160903316263.
Physicians commonly recommend 'placebo treatments', which are not believed to have specific efficacy for the patient's condition. Motivations for placebo treatments include complying with patient expectations and promoting a placebo effect. In this article, we focus on two key empirical questions that must be addressed in order to assess the ethical legitimacy of placebo treatments in clinical practice: 1) do placebo treatments have the potential to produce clinically significant benefit? and 2) can placebo treatments be effective in promoting a therapeutic placebo response without the use of deception? We examine evidence from clinical trials and laboratory experiments bearing on these two questions. The conclusion is reached that based on currently available evidence, it is premature to judge whether placebo treatments are ethically justifiable, with the possible exception of acupuncture for pain relief.
医生通常会推荐“安慰剂治疗”，因为人们认为这种治疗方法对患者的病情没有特殊疗效。采用安慰剂治疗的动机包括顺应患者的期望和促进安慰剂效应。在本文中，我们关注两个关键的实证问题，这些问题必须得到解决，以便评估临床实践中安慰剂治疗的伦理合法性：1）安慰剂治疗是否有可能产生临床显著的益处？2）在不使用欺骗手段的情况下，安慰剂治疗能否有效地促进治疗性安慰剂反应？我们考察了与这两个问题相关的临床试验和实验室实验的证据。结论是，根据目前现有的证据，判断安慰剂治疗是否在伦理上是合理的还为时过早，针灸治疗疼痛可能是个例外。
