BACKGROUND: According to a new survey, nearly half of American doctors report regularly giving their patients placebo treatments. For the purpose of the survey, the definition of "placebo" went beyond sugar pills. These "treatments" typically included vitamins or harmless drugs such as pain relievers, antibiotics or saline injections, which were disguised as medical therapies. Researchers from the National Institutes of Health sent out surveys to 1,200 internists and rheumatologists. They received 679 responses. Of those who responded, 62 percent found placebo treatments ethically acceptable. About half reported using the placebos several times a month. Of those who used placebos, 70 percent told patients the treatments were "a potentially beneficial medicine not typically used for your condition." Only 5 percent of doctors using placebos directly informed their patients of this fact. The survey found that, in some cases, placebos were given to patients with conditions such as chronic fatigue syndrome. Doctors also gave antibiotics to patients with viral bronchitis even though the virus is unreceptive to these drugs.

DO THEY WORK?: In 1955, in the ground-breaking research paper "The Powerful Placebo," researcher H.K. Beecher concluded that one-third of all patients responded to a placebo. According to the Food and Drug Administration, other studies show up to 75 percent of patients respond to sugar pills. A recent small study published in the Journal of the American Medical Association found antidepressants may be just a little more effective than a sugar pill for most patients. Other research shows placebos can help patients with cancer, irritable bowel syndrome and multiple sclerosis.

IS IT ETHICAL?: Many believe it is unethical for doctors not to disclose the use of placebo treatments to their patients. The American Medical Association's guidelines recommend that doctors only use placebos if the patient is informed and has consented. "In the clinical setting, the use of a placebo without the patient's knowledge may undermine trust, compromise the patient-physician relationship and result in medical harm to the patient," an AMA ethics panel said in 2006. Others argue disclosing this fact would counteract the potential effectiveness of the placebo treatment.