A majority of the physicians participating in the study said they do not view the practice as unethical. However, it flies in the face of the American Medical Association's policy: "Physicians may use placebos for diagnosis or treatment only if the patient is informed of and agrees to its use."

This AMA policy seems particularly cynical. Why not just oppose the use of placebos altogether? After all, the well-documented "placebo effect" is dependent on the patient's belief or expectation that the treatment might do some good. If placebos can only be administered along with advice that's sure to puncture that belief, they will almost certainly not trigger the effect.

For a long time, the placebo effect was viewed as merely psychological -- as though the mind were separate from the body and any effect it might produce would not be real.

Recent research has shown that the placebo effect can be physiological as well as psychological, supporting what many alternative healthcare practitioners see every day in their own practices: The mind and body are intertwined. Therefore, it seems to me, the definition of "placebo" needs to be changed.

If placebos can produce physiological changes in a patient's body, then how are they essentially different from other medications? They do have actual therapeutic value -- the process is just not well understood. Keeping patients in the dark should not be prohibited, it should be recommended. The effectiveness of the treatment requires it. It's not much different from other prescription instructions regarding how, when and under what circumstances particular drugs should be used.

Doctors often make unorthodox prescriptions when conventional forms of treatment fail. In many cases, side effects are potentially serious -- or even unknown. Patients are told that the treatment is experimental, that the results are uncertain. Surely there must be some way of couching the prescription of a placebo in language that will satisfy patients without undermining their belief that it might work.

That's not deception -- it's good medicine.

Transparency in doctor-patient relationships is extremely important, but this is one instance in which it makes sense to allow physicians the freedom to act in their patients' best interests.

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