Placebo Trials Case Study

Placebo Drugs

One of the most important factors involved in medical trials is probably ethics. Concerns like participant autonomy and informed consent are among the top priorities of the research clinician. This is why the use of placebos in clinical trials produces some murky waters, particularly with issues like the current Ebola crisis in Sub-Saharan Africa. While it is definitely acceptable to use a placebo in some cases, other cases produce crises of a dire enough sort to make the use of placebos unethical and potentially life-threatening.

The big debate around the Ebola trials focus on the ethics of using a placebo-medicated control group in trials that investigate medications that could save the lives of many. Indeed, one of the factors of such trials is comparing the mortality rate between the groups (Perrone). Surely an ethical boundary is being crossed here, since no Ebola sufferer would agree to a trial that is essentially a death sentence. In this case, I therefore believe that the use of placebos in trials is unethical.

On the other hand, the use of placebos in trials to test the efficacy of HIV drugs like AZT in the 1990s has proven greatly useful, since it meant the development of a new drug that could effectively treat the condition (Ethics in International Research, 1999).Since death was not imminent for any of the patients and the mortality rate was not the measure for efficacy, I feel that this was acceptable.

Other cases in which it is ethical to use placebos is in clinical practice, where authors like Lichtenberg, Heresco-Levy, and Nitzan (2003) point out that placebos can be highly effective in assuaging patient distress. Jones (2009), on the other hand, points out that patient autonomy and informed consent comes into the crossfire when placebos are given.

There is no simple answer for the question about placebo use. One might conclude, however, that informed consent should play a primary role when life and death are at stake.

References

Ethics in International Research. (1999). The Debate Over Clinical Trials of AZT o Prevent Mother-to-Infant Transmission of HIV. Retrieved from: http://www.hks.harvard.edu/case/azt/ethics/home.html

Jones, V. (2009, Mar. 18). Placebo Therapies: Are They Ethical? Science-Based Medicine. http://www.sciencebasedmedicine.org/placebo-therapies-are-they-ethical/

Lichtenberg, P., Heresco-Levy, P., and Nitzan, U. (2003, Jun. 2). The ethics of the placebo in clinical practice. Journal of Medical Ethics. 30 (6). Retrieved from: http://jme.bmj.com/content/30/6/551.full

Perrone, M. (2014, Nov. 12). Ebola drug testing sparks….....