Using placebos therapeutically requires extraordinary caution:
First, how placebos affect the mind remains to be elucidated.
Second, therapeutic placebo use entails deceit, which can seriously impair the doctor-patient relationship (which alone can have a strong placebo effect).
Third, the physician may misconstrue a salutary pla-cebo effect as evidence that the patient's illness is wholly or largely a neurosis.
Fourth, there is no legitimate program for health professionals that focuses on how and when to use placebos and on how to judge their effects.
Fifth, there are no standards for managing possible aftereffects of placebo administration—i.e., for dealing with any consequences of learning that a health problem and/or relief from it was "all in one's head." But the dearth of information on the placebo effect and the need for caution do not negate the legitimate findings of clinical researchers and should not rule out—or automatically render unethical—all therapeutic placebo uses by clinicians.
by Kenneth E. Legins
We are discussing here whether it is ethical prescribing harmless placebo but did we think about prescribing harmful unnecessary medications for a patient just to increase our income as experienced in some our doctors back home.
I have seen with my own eyes several patients holding a bag full of different medications which to my surprise some of them interact with each other.
Another common problem is ordering unnecessary expensive and sometimes invasive investigations e.g X-rays for the same reason mentioned above & when you ask why this doctor ordered "Liver or Renal Function Test" for a patient complaining of common cold or simple pneumonia, the answer will be: to lessen the patient's anxiety or unacceptable justification for "ruling out" other causing diseases!!!
To them, I say: please use your clinical reasoning and critical thinking to minimize your large differential diagnosis list before ordering such expensive tests.
Such behavior of prescribing dozens of medications and doing ultrasound for every patient complaining of abdominal pain created false belief among the community that a good doctor is always who gives bunch of drugs and scans the patients with his machine!!!!!!!......
By lessening the patient's anxiety or avoiding him the side effects of unnecessary drugs justifies the placebo prescription.