FC31-02 - Is it ethical not to prescribe placebo? the patient's perspective on the usage of placebo for the treatment of depression - a comparative study

Abstract

Introduction

The current stands of the medical establishment exclude usage of placebo in the clinical setting on ethical grounds. No attempt has been made to clarify the viewpoint of the psychiatric patient regarding the matter.

Objective

To compare the viewpoint of healthy subjects to that of patients who suffered from depressive episode.

Aims

1. 1) Investigate the willingness of subjects in both groups to receive placebo for the treatment of depression, and

2. 2) compare both groups’ views regarding the ethical aspect of placebo usage (e.g. doctor-patient relationship, patient's autonomy, etc).

Method

We enrolled 81 patients and 107 healthy subjects. Patients were recruited from an out-patient clinic and were diagnosed, in the past or present, as suffering from a depressive episode. All subjects were briefed thoroughly about the efficacy, potential benefits and limitations of placebo in treating depression and then completed a self-report questionnaire.

Results

64% of the patients (N = 50) expressed consent to use placebo in case they suffer again from depressive symptoms, compared to 79% (N = 85) of healthy subjects (p< 0.05). In both groups over 70% of the subjects do not perceive prescribing placebo as a deceit or as an act that diminishes the patients' autonomy (p>0.05).

Conclusions

The majority of patients agreed to receive placebo medication as a first line treatment, and do not feel that it will negatively affect their sense of autonomy or doctor-patient relationship. These findings question some of the ethical justification of excluding placebo from the clinical practice and call for further discussion in the subject.