I recently discovered that 97% of doctors in the UK have prescribed placebos. The general context seems to be within the mental health space, but I can’t find any firm restriction to the type of conditions that can be treated. I’m curious about what fundamentally underpins this ability legally on the part of the doctor.
A hypothetical scenario:
- I am depressed and speak to my doctor
- The doctor prescribes me what I am told is Blorpizine made by FooCorp, but actually it’s a sugar pill
- I go to a pharmacy and have to pay for the prescription. By its very nature, they would have to have all the FooCorp branding on the packet for me to believe the placebo, but it doesn’t contain any of the active components that the box lists so it’s not only falsely using the brand but all of the warnings on the leaflet are completely false about the potential side effects of eating sugar
- I actually start feeling better from the placebo effect. I speak at length to my best friend about how amazing this treatment is, as they’re also suffering
- They go to their doctor and, given a number of treatment options, they elect to go with Blorpizine because it was a personal recommendation by me. This is despite it being the riskiest option they were given.
- My friend is seriously injured in a suicide attempt after starting the the real medication because of a side-effect.
- News about FooCorp is mounting because this wasn’t the first time this effect has happened, so they’re plastered all over the newspapers and their brand slated, but it’s being prescribed at a higher rate than expected because of this placebo trend
- I stop taking “Blorpizine”, and then end up dead because I lose the placebo effect and I’m now more emotionally-damaged now than before. My friend finds out about this from the postmortem and they're... not happy.
So much seems to have gone wrong here across multiple parties based on the initial lie of one individual. I can find The Legal Implications of the Administration of Placebo to Psychiatric Patients but that primarily addresses point (2) and says nothing about the (in my mind, plausible) chain of events that happened next. What is the fundamental defence of my doctor for not precipitating my death, the severe injury of my friend, the brand deformation of FooCorp and probably innumerable other things? There must be some foothold for 97% of them doing it and not being sued continuously.
From the first article I linked, this makes no sense as a framework or defence in my hypothetical case:
In the UK, the GMC does not explicitly discuss or prohibit the use of placebos in the treatment of patients, other than mentioning placebos in a footnote of their research guidance. But the council's guidance does advise that doctors should always be open with patients, explain what they are prescribing and to answer a patient's questions honestly and fully.
'The GMC is silent on placebos, which leads to ambiguity,' believes Dr Howick. 'They do state that doctors "should not withhold information" from patients, as to do so would prevent the patient from providing informed consent. Since some ways of using placebos could involve the suggestion with the patient that the placebo is a "real" treatment, the GMC view is often interpreted by GPs as a ban on placebos.'