Authorized Deception: An Approach to the Effective and Ethical Use of Placebo Research
Regarding the ‘cost’ and ‘benefit’ consideration in deception used in placebo research, Miller, Wendler, and Swartzman (2005) are concluding that an appropriate balance between research value and ethical protection of research participants should and can be found and approved by the Ethics Committees.
Rather than looking at a specific amount of deception, a solution that is allowing using deception as a necessity to test the placebo effect effectively in an ethical manner is suggested by Miller et al. (2005) and called ‘authorized deception.’ Blease, Colloca, and Kaptchuk (2016) are calling the same approach ‘open -label placebo’ that is based on the disclosure of the possibility to research participants that deception can be used regarding the administration of true treatments or placebos. Such an approach has a big advantage that fully informed consent can be ensured (Miller et al., 2005). According to Martin and Katz (2010), participants in an experimental pain study were responding to the same extent to the placebo effect, whether they were left unaware of possible deception or not. Furthermore, patients seem to value informed consent over not being warned about the use of placebo (Martin & Katz, 2010). As recent study results indicate that open-label placebos are an effective research method (Petkovic et al., 2015), it is to hope that it will be used more frequently to protect participants from any unnecessary distress and researchers from ethical dilemmas damaging the reputation of research teams and the scientific field overall.
References
Blease, C., Colloca, L., & Kaptchuk, T. J. (2016). Are open-Label Placebos Ethical? Informed Consent and Ethical Equivocations. Bioethics, 30(6), 407–414. doi:10.1111/bioe.12245
Martin, A. L., & Katz, J. (2010). Inclusion of authorized deception in the informed consent process does not affect the magnitude of the placebo effect for experimentally induced pain. Pain, 149208–215. doi:10.1016/j.pain.2009.12.004
Miller, F. G., Wendler, D., & Swartzman, L. C. (2005). Deception in Research on the Placebo Effect. Plos Medicine, 2(9), 853–859. doi:10.1371/journal.pmed.0020262
Petkovic, G., Charlesworth, J. G., Kelley, J., Miller, F., Roberts, N., & Howick, J. (2015). Effects of placebos without deception compared with no treatment: protocol for a systematic review and meta-analysis. BMJ Open, 5(11), e009428. doi:10.1136/bmjopen-2015–009428
