Benutzer:DanSy/Nachweise

• [1]

Conclusion: Placebo is effective in the treatment of OA, especially for pain, stiffness and self-reported function. The size of this effect is influenced by the strength of the active treatment, the baseline disease severity, the route of delivery and the sample size of the study.

• [2]

The placebo effect is triggered by the person's belief in the treatment and their expectation of feeling better, rather than the specific form the placebo takes. [...] Belief in a treatment may be enough to change the course of a person's physical illness.

• [3]

That type of placebo effect seems most related to the degree of confidence and faith the patient has in the doctor or activity. [...] Shamans or medicine men would not have viewed their efforts as placebos. But their healing powers may have worked in the same way, partly through the patient's strong belief that the shaman's treatments would restore health.

• Marburger Erklärung (1993)

Wir leugnen nicht, dass sich mit "Homöopathie" mitunter therapeutische Wirkungen erzielen lassen, wobei es sich um so genannte Placebo-Effekte handelt. Und wird dann verglichen mit Irisdiagnostik; Reinkarnationstherapie; astrologische Gesundheitsberatung

• Lehrbuch zur Arzneimittelwirkung (2006)

So ist es nur scheinbar paradox, dass aus wissenschaftlich-medizinischer Sicht das homöopathische Arzneimittel meist als somatisch unwirksam angesehen werden muss, jedoch der homöopathischen Therapie (zu der das besondere Umfeld der Arzneimittelanwendung gehört) ihre Erfolge keineswegs abgesprochen werden. So gesehen, ist die Homöopathie eine Psychotherapie mit großen Erwartungen des Patienten und hoher Suggestivkraft bei den Therapeuten." Heinz Lüllmann, Klaus Mohr, Martin Wehling, Pharmakologie und Toxikologie, Thieme 16. Aufl. 2006, S. 65

• Der nützliche Betrug (2001)

Da wären einmal die Farbassoziationen: Blaue Tabletten oder Kapseln wirken sedierend, pinkfarbene stimulierend.

• Auf der Suche nach dem perfekten Placebo (2007)

Aus Sicht von Walach sind Placebobehandlungen manchmal sogar das Mittel der Wahl. "Neue Akupunkturstudien der Krankenkassen zeigen etwa, dass Placebo- oder Scheinakupunktur sogar wirksamer ist als die konventionelle Behandlung" [...] Nach einer Studie des Mediziners Michael Norup von der Universität Kopenhagen: jeder Dritte [Arzt] war davon überzeugt, dass sich durch die Placebotherapie sowohl das subjektive Empfinden als auch die objektive Symptomatik gebessert habe.

Abhandlung Placebo

Placebo hat keine Wirkung, das Stimmt aber so nicht

Es ist aus prinzipiellen Gründen unmöglich, Belladonna-Lösungen D60 und D100 herzustellen

Deutsches Ärzteblatt: Archiv "Homöopathie: Argumente und Gegenargumente" (12.09.1997)

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Interview mit Edzard Ernst, 2010

• Wenn Wasser, wie die Homöopathen behaupten, wirklich eine Art Gedächtnis hat, dann müssten die Lehrbücher der Physik neu geschrieben werden - und das ist im allerhöchsten Maße unwahrscheinlich. Wenn jemand wirklich zeigt, wie die Homöopathie wirkt - dann hat er nicht einen Nobelpreis in der Tasche, sondern mehrere.
• Vor allem aber liegt es daran, dass Homöopathie-Studien mit negativem Ergebnis einfach nicht publiziert werden.
• Die Homöopathen hingegen befinden sich mitten in einem Glaubenskrieg.
• Wenn eine Studie nicht das zeigt, was man sich erhofft hat, dann ist nicht etwa das geprüfte Mittel unwirksam, sondern die Methode wird angegriffen.
• SPIEGEL ONLINE: Es gibt aber auch einen anderen Studientyp, sogenannte Anwendungsbeobachtungen, die regelmäßig zeigen, dass weit mehr als 50 Prozent der Behandelten mit Homöopathie geholfen werden kann.

Ernst: Das ist totaler Schmarren! Diese Studien sind das Papier nicht wert, auf dem sie gedruckt worden sind. Über die Wirksamkeit der Homöopathie sagen sie nichts aus, das weiß jeder, der sich auch nur ein bisschen in der Wissenschaft auskennt.

• [Homöopathen & Studien als Beleg] Viele lügen wie gedruckt, das ist gar nicht anders zu erklären. Die wissen es eigentlich besser. Aber stattdessen nutzen sie ihre Kenntnis der Wissenschaft, um die Leute hinters Licht zu führen.
• Jede nicht effektive Behandlungsmethode birgt große Gefahren. Die Homöopathie hat zwar, da sie keine Wirkung hat, auch keine Nebenwirkungen. Aber die Gefahr ist, dass ernsthafte Krankheiten nicht effektiv behandelt werden, wenn Patienten einen Homöopathen aufsuchen
• SPIEGEL ONLINE: Tatsache ist, dass die Schulmedizin den Patienten oft auch schadet - insbesondere solchen, die an nur schwer fassbaren, psychosomatisch bedingten Störungen leiden und dann jahrelange Patientenkarrieren durchlaufen. Sie bekommen unnötig Psychopharmaka, Schlafmittel, Schmerzmittel und werden sogar unnötig operiert. Könnte da die Homöopathie als vergleichsweise harmlose Placebotherapie nicht sinnvoll eingesetzt werden?

Ernst: Natürlich drängt sich dieser Gedanke erst einmal auf. Aber es kann für mich kein ethisches Verhalten sein, einem Patienten nicht die Wahrheit zu sagen und ihn stattdessen einfach mit einer Scheintherapie zu behandeln.[...] Ich glaube, dass Ehrlichkeit ein wichtiges Gebot in der Medizin ist. Das unehrliche Verhalten hilft dem Arzt vielleicht kurz aus der Bedrängnis, aber das ist nicht der richtige Weg. Es kann nicht darum gehen, ein großes Übel, also eine falsche schulmedizinische Therapie, durch ein kleines Übel, die Homöopathie, zu ersetzen.

Interview mit Edzard Ernst, Juli 2008

• Im Unterschied dazu setzen Hausärzte zum Beispiel einzelne homöopathische Mittel intelligenter als man meint: In einigen Fällen weiß der Arzt nämlich schlicht nicht, was er tun soll: Es steht vielleicht keine Diagnose fest, zumindest keine behandelbare Diagnose, der Patient will aber mit einem Rezept nach Hause gehen. Da schreibt man eben nicht «Placebo» sondern Arnika D30 oder sonst irgendwas drauf. In Deutschland wird Homöopathie von sehr vielen niedergelassenen Ärzten eingesetzt – schätzungsweise 70 Prozent der Hausärzte machen das.

• Bei der Homöopathie dagegen: 200 kontrollierte klinische Studien, bei denen unterm Strich nichts rauskommt und dazu noch eklatante biologische Unplausibilität…

• Netzeitung: Was halten Sie vom Argument der Jahrhunderte alten Tradition?

Edzard Ernst: Es gibt da ja sehr prominente Beispiele in der Geschichte. Nehmen Sie den Aderlass. Den gab es in nahezu allen medizinischen Kulturen, und der hat sicherlich Millionen Menschen das Leben gekostet und wurde dennoch lange praktiziert. Als dann mit den ersten klinischen Studien in der Geschichte der Medizin wahrscheinlich gemacht wurde, dass der Aderlass nicht hilft, hat man schon damals die Sinnhaftigkeit der klinischen Studie angezweifelt, aber nicht den Aderlass selbst. Dafür gibt es hunderte von ähnlichen Beispielen.

The truth about homeopathy (Juni 2007)

• These two tell us that 1) homeopathy is biologically implausible, 2) its own predictions seem to be incorrect and 3) the clinical evidence is largely negative.
• Today, however, we know a lot more, and comprehend that they are not in line with much that science has taught us.
• Assessing the totality of these provings in a systematic review, homeopaths were recently surprised to find that ‘the central question of whether homeopathic medicines in high dilutions can provoke effects in healthy volunteers has not yet been definitively answered’
• Dozens of such reviews [systematic review of all studies of acceptable methodological quality] are available today. The vast majority of those that are rigorous conclude that homeopathic medicines fail to generate clinical effects that are different from those of placebo

Heilerfolge basieren auf dem Placebo Effekt (10. April 2005)

• Ich behaupte gar nicht, daß Homöopathie nicht wirkt. Aber ich bezweifle, daß sie spezifisch wirkt, das heißt aufgrund der verabreichten Wirkstoffe in ihren homöopathischen Dosierungen.

Efficacy of Homeopathic Arnica (1998)

• Homeopaths believe that "potentizing" in this way will not reduce but rather increase the activity of the resulting remedy. It is in particular the use of highly diluted material that overtly flies in the face of science and has caused homeopathy to be regarded as placebo therapy at best and quackery at worst.

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House of COMMONS, ORAL EVIDENCE, 25 November 2009 & 30 November 2009 (von da)

• Q112 Mr Stringer: [...] is there any evidence that homeopathy shows any efficacy beyond the placebo effects?

Professor Edzard Ernst, [Director, Complementary Medicine Group, Peninsula Medical School] I would echo what has been said and warn people to pick cherries out of a bigger cake; if you look at the bigger cake the bottom line is there is no good evidence that homeopathic remedies are better than placebos.

• Q116 Mr Stringer: Just on the first part of the question, do you believe that NHS spending should be based on efficacy or effectiveness?

I would add, however, that without efficacy effectiveness can be quite meaningless, and there are trials that are designed in such a way that, for instance, could test standard care plus homeopathy versus standard care alone. If you understand what homeopathy entails, the empathetic encounter of one hour of empathy and understanding towards the patient, it is predictable that such a trial will generate a positive result simply because of its non-specific effect - its placebo effects - and therefore because it is predictable (and we have shown that this is predictable) such a trial should not be done because you know the result before the trial, and arguably such a trial is even unethical.

• Q120 Mr Stringer: is it ethical for the NHS to prescribe placebos? Should the NHS prescribe placebos?

I would argue it is unnecessary, unreliable and unethical to prescribe placebos through the NHS; unnecessary because if you do it well then an active treatment will also generate a placebo effect. If I give my patient an aspirin for his or her headache and I do it with empathy, time and understanding this patient will benefit from the pharmacological effect of the aspirin and she will also benefit from the placebo effect through the encounter with her clinician. It is unreliable and there is lots of data to show that placebo effects are notoriously unreliable; somebody who responds today may not respond tomorrow; responses are not large in effect size and they are not usually long-lasting. Foremost, it is unethical. That is my third point.

• Q130 Mr Stringer: The question was should the money that is spent on homeopathic consultations be redirected within the NHS?

If the NHS's commitment to evidence-based medicine is more than lip service then, surely, money has to be spent for treatments that are evidence-based, and homeopathy is not.

• Q136 Dr Harris: Four out of five seems to be a majority. Would you comment on that? Have there only been five systematic reviews and do they show that positive result, in your opinion?

I have supplied you with a list of systematic reviews as published a few years ago, and in that list there are already, I think, almost two dozen.

None in that list, which was after a very prominent systematic review and meta-analysis by Klaus Linde was published in The Lancet, including the ones we analyse in The Lancet data including Linde re-analysing his own data, none of these systematic reviews were positive.

• Q138 Dr Harris: Why do you think that homeopaths say that systematic reviews are positive if it seems to you that they are not positive? Both sides cannot be right.

[...] When you do that indeed the majority of publications is positive, but in a systematic review, typically, you define your entry criteria and we usually define them as randomised clinical trials - if possible, randomised placebo controlled clinical trials and in homeopathy that is possible - and the vast majority of these systematic reviews do not confirm that homeopathic remedies are more than placebos.

• Q151 Dr Harris: [...] the memory of water and a physiological impact [...]

Even if the water is different it leaves totally unanswered the question of how it exerts any health effects in human bodies. The water in my kitchen sink is also different from distilled water yet it is unhealthy and not healthy.

• Q84 Ian Stewart: Tracey Brown, [Managing Director, Sense About Science], can any of you say categorically that homeopathy does not work in any circumstances to reduce illness, ailments or adverse conditions? (Q86 Ian Stewart: Other than the placebo effect)

Ms Brown: I have not seen any evidence to suggest there is any systematic benefit beyond the placebo benefit.

Q87 Ian Stewart: That is not what I asked; I asked if you could categorically say that it does not work?

Ms Brown: Yes. Insofar as I can categorically say anything in this life, I would say yes.

• Q18 Chairman: Professor Jayne Lawrence, [Chief Scientific Adviser, Royal Pharmaceutical Society of Great Britain], do you believe that homeopathic remedies work beyond the placebo effect?

Professor Lawrence: No, we do not believe there is any scientific or clinical evidence, using standard clinical trials, that there is ---

Q19 Chairman: Even for arnica?

Professor Lawrence: I have not seen this latest trial, but certainly up until recently we reviewed all the evidence and we believe there is not any clinical or scientific evidence supporting their use.

Q20 Ian Stewart: Does that mean they do not work at all? Are you very definite that they do not work at all?

Professor Lawrence: Some patients, a lot of patients in fact, claim to have benefited, if they are asked afterwards, from the therapies.

Q21 Ian Stewart: That is a different issue.

Professor Lawrence: There is no evidence that we can see that supports ---

Q22 Ian Stewart: It is only that there is no evidence. You are not saying that that does not mean that they work in some cases?

Professor Lawrence: There is no scientific basis for their being effective. There is no reason why they would be effective scientifically.

• Q23 Chairman: Dr Goldacre, what is your view? Is there any effect beyond the placebo effect?

Dr Ben Goldacre: No. The placebo effect is undoubtedly very powerful, and that is one reason why they are very attractive to people, but if you look at all of the trials in the whole, collectively, what you see when you look at the best quality trials is that homeopathy pills work no better than placebo pills. You can select individual trials and say: we have got this individual trial, or even ten individual trials, which show that it works, but if you cherry-pick your literature and pick out only the positive results and ignore the unfavourable results, you can make any treatment work, including ones that are known to be ineffective or even dangerous. That is just bad scholarship.

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Viele Menschen glauben an alternative Behandlungsmethoden wie etwa die Homöopathie. (Feb 2006)

• Prof. Müller-Oerlinghausen: "Es gibt natürlich gute Gründe für Versicherungen, die Homöopathie in ihren Leistungskatalog mit hinein zu nehmen. Das ist einfach die Jagd nach dem Kunden."

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"Alternative Heilmethoden": Eine Art Glaubenskrieg (1998)

• Prof. Dr. med. Bruno Müller-Oerlinghausen.: "Es gibt genügend Beispiele dafür, daß Ärzte, die sich besonders viel Zeit für ihre Patienten nehmen, mit weniger Arzneimitteln auskommen" [...] Fazit: "Wir brauchen keine Homöopathie oder andere esoterische Heilverfahren als Ersatz für die sprechende Medizin. Dies kann hervorragend und auf dem wissenschaftlichen Stand des 20. Jahrhunderts von der Schulmedizin geleistet werden, wenn die entsprechenden Rahmenbedingungen für die praktizierenden Ärzte geschaffen werden."

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Die ungewollten Trials einfach wegstreichen, cool:

• A subset meta-analysis showed that homeopathic medicines are probably not helpful in muscle soreness (OR51.30; CI: 0.96e1.76; P50.093; I250%), as already had been suggested by others before [33]. When we restricted our analyses to the remaining 17 trials, we found an overall statistically significant effect[4]

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• Prof. Dr. Martin Lambeck: Eine Revolution der Physik?

Die Lösungsmittel Wasser und Alkohol sind keineswegs vollkommen reine Stoffe. Das sauberste Lösungsmittel, das das Arzneibuch kennt, ist „Wasser für Injektionszwecke". Dieses darf noch Nebenbestandteile wie z. B. Kalk- oder Eisenverbindungen enthalten, deren Konzentration etwa D6 entspricht.

Interview mit Edzard Ernst, 2010

• Edzard Ernst: Ich denke, es hat viel damit zu tun, dass die Schulmedizin es nicht versteht, das tiefe Bedürfnis der Patienten nach Zuwendung zu befriedigen. [...] Die Homöopathie ist eine sehr empathische Methode, eine Konsultation dauert oft länger als eine Stunde. Es gibt sogar Hinweise darauf, dass diese Konsultation, anders als die Globuli, durchaus eine Wirkung hat - als eine besondere Form der Psychotherapie.

The truth about homeopathy (2007)

• The discrepancy between the trial and the observational data continues to be hotly debated. Personally, I find this somewhat puzzling. The explanation seems obvious: patients often do improve for a number of reasons unrelated to any specific effect of the treatment we prescribe
• Amongst all the placebos that exist, homeopathy has the potential to be an exceptionally powerful one – think, for instance, of the individualized remedies or the long and empathic encounter between patient and therapist.

Viele Menschen glauben an alternative Behandlungsmethoden wie etwa die Homöopathie. (Feb 2006)

• "Man kann nur annehmen, dass sie in einer häufig wirklich begabten und eindrucksvollen Weise eben eine Placebo-Therapie betreiben", so der Kommentar von Prof. Bruno Müller-Oerlinghausen.
• ("Die Wirksamkeit schätze ich insbesondere im Bezug auf die sprechende Medizin - so nenne ich das immer gerne - ein", sagt Ralf Sjuts von der Deutschen BKK.)

"Pharmakologie und Toxikologie" Von Heinz Lüllmann, Klaus Mohr, Martin Wehling (2006)

• Die Analyse des Symptomenmusters erfordert, dass der homöopathische Therapeut den Patienten intensiv befragt. Auf diese Weise kann der Patient ein Aussmass an menschlicher Zuwendung erfahren, wie er es in der wissenschaftlichen Medizin zuvor nicht erlebt hat.

1: Anthony Campbell, Homeopathy In Perspective 2004 / 2: 2008

• If we consider the ’standard’ homeopathic consultation, by which I mean the Kentian version, it is undoubtedly well suited to maximize the placebo effect, for a number of reasons. First, it takes a long time; most homeopaths like to allow at least 45 minutes for a first consultation and many prefer an hour or more. Second, patients feel that they are being treated ’as an individual’. They are asked a lot of questions about their lives and their likes and dislikes in food, weather, and so on, much of which has no obvious connection with the problem that has led to the consultation. Then the homeopath will quite probably refer to an impressively large and imposing source of information to help with choosing the right ’remedy’. [1,96][2,142]

• In retrospect, however, I think it more probable that the ritual of preparation witnessed by the patient was in itself impressively therapeutic and that the superior efficacy of [the home-made|our] medicines was due to this.[1,97][2,144]

• However, homeopaths generally pride themselves, often with justification, on being people with good powers of intuition and empathy; indeed, unless they have these abilities they will not succeed in their profession.[1,97][2,145]

• So is the therapist no more than a sympathetic friend? No; this is where the theory comes in. It often doesn’t matter much what a therapist’s theoretical beliefs are (provided they are not actually dangerous, of course); their function in many cases is not to be ’right’ but to provide a framework to keep the discussion in focus. The homeopath is not just chatting vaguely and asking questions at random, but is trying to use what the patient is saying as a guide to the right remedy. This gives the interview a frame of reference and prevents it from becoming totally shapeless. [1,98][2,147]

Aijing Shang, Are the clinical effects of homoeopathy placebo effects? (2005)

• Context effects can influence the effects of interventions, and the relationship between patient and carer might be an important pathway mediating such effects. Practitioners of homoeopathy can form powerful alliances with their patients, because patients and carers commonly share strong beliefs about the treatment’s effectiveness, and other cultural beliefs, which might be both empowering and restorative.

Homeopathy has clinical benefits, Sarah Brien (2010)

• Conclusion. Homeopathic consultations but not homeopathic remedies are associated with clinically relevant benefits for patients with active but relatively stable RA.

Prognosis or "curabo effect?" Bertrand Graz (2005)

• For patients receiving a treatment not meeting explicit criteria of appropriateness, more optimistic physician expectation was associated with better improvement of psychological dimensions. Besides prognostic ability, the influence of physician expectation on patient outcome is discussed and the concept of "curabo effect" (differentiated from "placebo effect") proposed.

Components of placebo effect, Ted J Kaptchuk (2008) Kommentar Bertrand Graz und Edzard Ernst

• Interventions: For three weeks either waiting list (observation), placebo acupuncture alone ("limited"), or placebo acupuncture with a patient-practitioner relationship augmented by warmth, attention, and confidence ("augmented"). Results: All pairwise comparisons between augmented and limited patient-practitioner relationship were significant: global improvement scale (P<0.001), adequate relief of symptoms (P<0.001), symptom severity score (P=0.007), quality of life (P=0.01).Results were similar at six week follow-up.

Placebolotherapy, Nick J Woodhead, Mental Health Act coordination manager (2008)

• Placebolotherapy—the standard by which all other treatments are measured. At least as effective as all types of psychotherapy and all “alternative” healthcare treatments. Treats physical health conditions and mental health problems (especially mood disorders). Evidence based.
• Placebolotherapists spend an hour with the “patient” in a pleasant room, giving them their full and undivided attention. They explain that what they are doing is backed up by rigorous scientific evidence, is extremely effective, and that the patient will feel better afterwards. That’s it. Cost £50 a session. Research into placebo shows that the more value the patient puts on it, the more effective it is (a placebo injection is more effective than a placebo pill), so an expensive session will be more effective than a cheap one.

Steven Novella, Placebo Effects Revisited (2010)

• Existing evidence strongly suggests that placebo effects are mostly comprised of bias in reporting and observation and non-specific effects. There is no measurable physiological benefit from placebo interventions for any objective outcome. There is a measured benefit for some subjective outcomes (mostly pain, nausea, asthma, and phobias), but the wide variation in effect size suggests this is due to trial design (and therefore bias) rather than a real effect.

An exploratory study of the contextual effect of homeopathic care. 2007

• Conclusions: In this innovative and exploratory study, there was no evidence for a clinically relevant effect of homeopathic care vs. a homeopathic medicine given by the child's parents and based on a pre-agreed homeopathic treatment protocol. Hier ist der Effekt der Eltern als Autorität nicht berücksichtigt.

Nuhn T, Lüdtke R, Geraedts M., Placebo effect sizes in homeopathic compared to conventional drugs (2010)

• CONCLUSIONS: Placebo effects in RCTs on classical homeopathy did not appear to be larger than placebo effects in conventional medicine.

• Q32 Dr Harris:

Robert Wilson, Chairman, British Association of Homeopathic Manufacturers: .... If you look at a number of the experts in trials, they will always say size is the only thing that matters. When you talk about a trial, the second question you should ask is how big was the sample? Any sample of fewer than 500 is not going to be statistically relevant.[5]

• Q255 Dr Harris:
• Professor David Harper CBE, Director General, Health Improvement and Protection, and Chief Scientist, Department of Health: ...homeopathic practitioners would argue that the way randomised clinical trials are set up they do not lend themselves necessarily to the evaluation and demonstration of efficacy of homeopathic remedies...[6]

• Doppelblindstudien sind für Hömöopathie nicht geeignet[7].

• Dr Robert Mathie, Research Development Adviser, British Homeopathic Association: ...There are something like 37 of them, if I remember offhand, where there is positive evidence. There are another 50 in which there is inconclusive or perhaps negative evidence. What I would make a plea for is that the efficacy studies that do exist [...] should transform gradually over time with active research into effectiveness research ...where those homeopathic medicines that are shown to be effective are used within the armamentarium of the homeopathic process because, after all, what has not become fully clear this morning is that homeopathy is a system of care. There are 3,000 homeopathic medicines in the pharmacopoeia. We need to understand the efficacy of each...

George Vithoulkas, Another Point of View for the Homeopathic Trials and Meta-Analyses (2009)

• Are the bulk of the trials reviewed in these meta-analyses reliable? The answer is a clear “no”. My objection is that all these trials were not structured according to the well established principles of homeopathy. Homeopathy demands individualization of the cases in order to show its best therapeutic effect. But in almost all the trials reviewed in the 6 meta-analysis studies these critical parameters were obviously ignored.

• Die Meinung der Académie nationale de Médecine[8] (2004)
• Stellungnahme der Arzneimittelkommission der deutschen Ärzteschaft (1998)
• Science and Technology Committee, Evidence Check 2: Homeopathy, Report published (2010)

• Pressure grows against homoeopathy in the UK (2007)

Michael Baum, professor emeritus of surgery at University College London and frequent critic of homoeopathy, thinks that homoeopaths are getting over-confident. “People say homoeopathy cannot do any harm but when it is being promoted for HIV then there is a serious problem”, he says.

Baum is not alone in his concern about the potential dangers of homoeopathy. Last year, an undercover investigation by charity Sense About Science, showed that the first ten homoeopathic clinics and pharmacies selected from an internet search and consulted were willing to provide homoeopathic pills to protect against malaria and other tropical diseases such as typhoid, dengue fever, and yellow fever. “Making false claims about treating colds is one thing but it is quite another thing to make false claims about malaria”, says David Colquhoun, professor of pharmacology at University College London.

The thinking doctor’s guide to placebos, (2008)

• We think that doctors can use placebos ethically while remaining within the spirit of scientific, evidence based medicine. To be evidence based, they should prescribe placebos similar to those used in randomised controlled trials that show an improvement over baseline. Clinicians could then be confident of the strength of the evidence and could then tell patients that treatment X has been shown in trials to result in improvement in similar patients.
• If these principles are adhered to, placebo treatments would not only be evidence based and cost effective but would offer the best option for respecting patients’ autonomy.

The thinking doctor’s guide to placebos, (2008)

• For many patients a low risk of side effects is more important than a high probability of relief of symptoms. Indeed, where an effective placebo treatment exists for a condition, not offering it may be unethical, as we cannot second guess the importance that patients attach to different effects (or side effects) of the treatment. Anecdotally, we have seen many risk averse patients who would happily accept reduced benefits for much reduced risks.