Prescribing Placebos
Written by Abigail Gillespie
Ms. Gillespie, a frequent patient at Adams County Regional Medical Center, is difficult. Dr. Sterling, her regular doctor, notes that her file is getting quite thick as she has been coming in regularly for the last couple of years. Ms. Gillespie is 34 years of age, a white woman, and fairly healthy despite being slightly overweight. Just two weeks before, Dr. Sterling did extensive diagnostic testing, but everything came back normal.
Today, Ms. Gillespie mentions feeling incredibly fatigued and bloated, and asks if there is any kind of treatment that will help. Dr. Sterling performs a physical exam, but decides that she does not need any medication. Nothing seems to be wrong in the physical sense. She feels that Ms. Gillespie needs a psychiatric examination, but understands that her unwillingness to do so is a result of financial instability. Dr. Sterling has often wondered if Ms. Gillespie suffers from a mental disorder, specifically a factitious disorder. Dr. Sterling decides to give Ms. Gillespie a vitamin injection (a placebo). This way, Dr. Sterling is prescribing a treatment, but it doesn’t have any active properties that could indirectly harm Ms. Gillespie.
Questions:
If Ms. Gillespie learns that she was given a placebo, how will she learn to trust medical professionals again?
When taking birth control, people know that the last week of pills are just sugar pills. This is considered ethical. What difference would lead many people to think that the situation of Ms. Gillespie is unethical?
What ethical principles did Dr. Sterling violate?
What else could Dr. Sterling have done to handle the situation?
When would a placebo be ethical to use?
Works Cited
Journal of Lancaster General Health - Placebos and Factitious Illnesses, http://www.jlgh.org/Past-Issues/Volume-6---Issue-1/Placebos-and-Factitious-Illnesses.aspx.
Resnick, Brian. “The Weird Power of the Placebo Effect, Explained.” Vox, Vox, 7 July 2017, https://www.vox.com/science-and-health/2017/7/7/15792188/placebo-effect-explained.
