Ethics Blog.

I've been following Jim Sabin's blog on ethics.

Jim has been in health care for 45 years. He's worked as a psychiatrist, medical director, teacher/ researcher, consultant, and leader of the ethics program at a health insurer.

http://healthcareorganizationalethics.blogspot.com

Jim had recently posted about the ethics of using placebos in clinical practice.

I made this comment at his blog:

I’m a Recreational Therapist. We’ve been referred to as “applied social psychologists.” I’ve always questioned, is placebo a bad thing if it has a positive outcome? Of course, I wouldn’t deceive anyone. I suppose I’m talking more about a self-fulfilling prophecy where the individual realizes or makes a pre-determined thought come true. Here is another example: The pain scale is universal. What matters is how the person perceives and is able to cope with level of pain. If an activity intervention causes the patient to feel less pain, then, for the patient, who perceives it, the activity would be effective. If a person feels better because of a placebo treatment (in this case where the patient is aware that it is placebo – but is effective) would it be a bad thing? We want our patients to feel better. Of course, as a Recreational Therapist, I know the importance of providing treatment interventions that are grounded with evidenced-based outcomes that are proven to be effective. These are some of my random thoughts. I always enjoy your blog entries. Yours,
Danny, Recreational Therapist.

I was pleased to receive the following reply:

Hi Danny -I love the idea of your profession being called "applied social psychologists." I believe that even in areas of health care that are very "technical" - surgery, cancer treatment, etc - "social psychology" plays a significant role for many of our patients. And I agree with your sense that there's nothing wrong with what gets called "placebo effect." In another culture the interpersonal component of healing and health promotion might be put on a pedestal rather than demeaned as "only a placebo effect." As I said in the post, the suggestion that clarity about what is being done when we prescribe a placebo doesn't undermine the effectiveness of the action will make it easier for clinicians and patients to respect what they're doing. As you say, our aim is to bring relief and promote well being, and within broad limits, whatever promotes those aims should be seen in a positive light!I'm glad you enjoy the blog entries. I enjoy writing them!

Best,
Jim

Your can read his full blog entry on ethics for using placebos here:

http://healthcareorganizationalethics.blogspot.com/2011/01/ethics-of-using-placebos-in-clinical.html