Placebo Treatment
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Placebo is defined as a psychological treatment that is given to patients in order to improve their health conditions. The positive effects of placebo treatment are related to the strengthening the patient’s belief and raising positive expectations from the medicine (Proyer et al., 2014). The power of positive thinking and subconscious cues of a patient play an important role in triggering the placebo effect. The treatment requires giving inactive substances such as sugar, saline solution, or distilled water to the patient instead of the specific treatment. This essay describes the reason for which placebo treatments should be encouraged to be used in hospitals. Moreover, the role of cardiology in the placebo effect and sham surgery, which is a part of the placebo treatment, are also discussed for providing insight into the biological mechanism involved in treating patients.
Placebo treatment becomes the best available treatment for some patients in some situations. It is subjective and does not work on unconscious or asleep patients. Also, anything that can be measured objectively cannot be treated with placebos such as a bone fracture or even cancer. It is more for elusive complaints such as indigestion, depression, headaches, or shortness of breath. Various examples of the successful placebo effect can be found in the literature. For example, Dr. Ted Kaptchuk, director of the Harvard placebo program, and his colleagues conducted an open-label placebo study (Zhao et al., 2010). The patients were told about placebo and its powerful effects before the treatment. It was found that even an open-label placebo was successful, and the findings revealed that 20 % improvement of health took place when compared with no treatment.
It is often argued that if the physician lies to the patient about the medicine and tells him that he has been given morphine or penicillin instead of telling the truth about the sugar pill, he is guilty of an unethical lie (Fletcher, 2015). The study by Dr. Kaptchuk proves that if the physician remains up-front with the patient and tells him about the placebo prescription, it would still benefit the patient, given that the placebo has no major drawbacks. However, if the patient is told that the pill will make him feel better than before, the physician has not lied. Deception is also justified when a patient’s welfare is concerned. In a study by Benedetti (2016), it was found that the placebo treatment was effective in 35 % of the patients. Placebo effect was not considered in isolation, and other factors such as answers of politeness, conditioned answers, and fluctuation of symptoms were also taken into consideration.
Placebo has been found to influence the brain, immune, respiratory, and cardiovascular system (Colloca & Benedetti, 2005). The effect of placebo treatment depends on the behavior of different individuals, and therefore correlation does not imply causation in all circumstances. The study at Duke University Medical Center showed that heart patients had a better chance of survival if they consciously take their pills even if they are placebo (Teerlink et. al, 2013). Sometimes people experience high blood pressure with a new doctor; others feel relaxed just in the presence of a physician. Joram Ronel, MD, Technische Universität München in Munich, in one of his researches, evaluated the placebo-induced chest pain improvement to understand if it could be a result of changes in coronary blood flow (Noll-Hussong et al., 2013). The results strengthened the view that psychosocial impacts including verbal signals and expectations directly influence coronary physiology.
Sham surgery is a placebo treatment that involves the use of needles, which retract into the handles, instead of penetrating the skin. The patient experiences the same incidental effects of an operation as a patient who undergoes a true surgical procedure (Wartolowska et al., 2014). Sham surgery as a placebo treatment has been used to cure Parkinson’s disease, which is a degenerative movement disorder. There was a 20-30% improvement in motor score of patients treated with Sham surgery (Hostiuc et al., 2016). It was also found that the active surgical procedure was not associated with any significant improvement versus the sham procedure. The researchers of Harvard’s placebo studies program also published a study in 2008 to illustrate the favorable reaction of patients experiencing sham procedures. People with irritable bowel syndrome (IBS), a condition that causes abdominal pain and changes in bowel movements, volunteered for the study (Dossett et al., 2015). The placebo effect, in this case, was remarkable: 44 % of the patients reported relief from their problem just because of sham acupuncture needles. The results improved to 62 % of the patients reporting relief when sham acupuncture was combined with an attentive interaction with the acupuncturist.
Treatment with placebo has frequently been observed to be effective and robust with patients facing various health issues. It can, therefore, not be termed as a non-treatment, and the hospitals should be encouraged to use it for increasing the chances of speedy recovery of patients. Cardiology and sham surgery have been found to support the placebo effect. These effects have been shown to be influenced by such factors as expectancy, conditioning, and physiological measures. Moreover, the effectiveness and the response of a placebo treatment also depend on the doctors’ expectation regarding the patient receiving a placebo treatment. For the placebo treatment to be termed as ethical, it is important that a trust between the physician and the patient is maintained. Studies suggest that patients are more likely to experience positive placebo effects if they are confident about their doctor.
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