Truth telling, placebos, and deception: ethical and legal issues in practice.

The issue of truth-telling is very complex. There is variance among patients in the amount of information they want to be told and variance among professionals in the amount of information they want to tell. Truth is conditioned by our knowledge limits and understanding. Technological advances in health care have made this arena even more complex. Placebos have been viewed traditionally as a kind of benign deception. Few studies have looked at treatments and tests as placebos. There are many myths associated with placebos and placebo therapy. There are five primary theories for withholding the truth or promoting deception with patients. Ethical and legal principles generally support veracity and the concept of a duty to tell the truth. One of the remaining issues is whether the placebo effect can be achieved without deception.