Exquisite management of end-of-life pain is a medical imperative. Use of a placebo in place of known effective pain medication for determining whether the patient is really in pain is under no circumstances appropriate. Use of placebos does not meet the accepted criteria to diagnose substance abuse, commonly referred to by some physicians as “addiction.” There is no medical justification for the use of placebos to assess or treat patients in pain at end of life.
The only appropriate use of a placebo is in approved clinical research with informed consent.
The Committee would like to thank Frederick J. Goldstein, PhD, FCP, professor of Clinical Pharmacology, Department of Neuroscience, Physiology and Pharmacology; director of Research, MEDNet; and director, Clinical Master of Science Program, Philadelphia College of Osteopathic Medicine, for his contributions to this paper. The Committee would also like to thank Michael A. Seffinger, DO, assistant professor of Family Medicine/Osteopathic Manipulative Medicine, Western University of Health Sciences College of Osteopathic Medicine of the Pacific, Pomona, Calif.