A Duty to Deceive: Placebos in Clinical Practice
A Duty to Deceive: Placebos in Clinical Practice
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DOI：
10.1080/15265160903318350
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发表时间：
2009-01-01
影响因子：
13.4
通讯作者：
Foddy, Bennett
中科院分区：
文献类型：
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作者：
Foddy, Bennett
在医学研究人员和临床医生中，主流观点是，通过开安慰剂来欺骗患者是不道德的。这一观点在美国医学会(AMA[伊利诺伊州芝加哥])最近发布的一项政策中得到了正式表达。尽管安慰剂可以被证明总是安全的，通常是有效的，有时是必要的，但医生现在实际上被禁止在临床实践中使用它们。我认为，在临床实践和医学研究中，欺骗性服用安慰剂不会受到其他形式的欺骗的道德反对。尽管欺骗通常是令人反感的，理由是它限制了自主权并违反了信任，但如果安慰剂是在适当的道德限度内开出的，这些理由就不适用于安慰剂。患者有理由希望医生以符合道德责任的方式开出安慰剂。因此，美国医学会有义务认可并促进在临床实践中负责任地使用欺骗性安慰剂。
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.