Why Are Placebos Important in Research? Q and A with Ted Kaptchuk

Hi I’m Ted Kaptchuk. I’m a Professor of Medicine at Harvard Medical School. And I’m Director, of the Program in Placebo Studies and the Therapeutic Encounter, which is hosted at the Beth Israel Deaconess Medical Center. Placebos generally are not used by health care providers to treat a patient, but why are they important in research? The question of “When do we use placebos?” In general, any health care provider is not allowed to deceive a patient. You can’t give a person a sugar pill or cellulose pill and say “This is a real drug.” That’s absolutely unethical, there’s no transparency there, it involves deception. That said, there are two situations that, one situation that’s indispensable to use placebos, another that’s interesting. The one that’s indispensable is that when we do research trying to study the effect of a drug we compare it to a placebo.

Meaning sometimes because people’s illnesses get better by time. Tincture of time is real. And we want to find out if the drug really works or is it really time and spontaneous remission? So we do what is called double blind experiments, where neither the provider, or the researcher, or the patient knows that they’re getting a drug or placebo and the patient has to be told about the procedure and has to sign an informed consent. That’s a way of protecting the patient. There’s another situation where people are just beginning to think about, can you give placebos and tell people they might work? It’s still, it’s very early in infancy that kind of research. But right now, in general, that would be ethical, if you’re honest. But right now, in general, we say that placebos, especially in the context of deception, is not an ethical thing to do.

But in research for drug development, placebos are really indispensable..

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