The ethics and epistemology of placebos

There is an ongoing tension between the ethics and epistemology of placebo-controlled trials (PCTs). The clinicians’ moral duty to provide the best available care seems to preclude using placebo controls when there is an established effective treatment. Yet the Declaration of Helsinki appeals to ‘methodological and scientific’ reasons to justify using placebo controls even if there is an established therapy. In this session we will examine the justifications for the claim that placebo controlled trials enjoy methodological benefits over and above trials that used established
therapies as controls.

Core reading: Howick J (2009). Questioning the Methodologic Superiority of ‘Placebo’ Over ‘Active’ Controlled Trials. American Journal of Bioethics 9(9):34-48. doi: 10.1080/15265160903090041. PMID: 19998192