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Every second doctor in Germany has given a placebo before. In some cases, the German Medical Association recommends that medical practitioners increasingly resort to sham preparations.
Every second doctor openly admits that he has already prescribed an ineffective medicine to a patient. This is reported by a current study by the German Medical Association in Berlin. However, this fact as such is not a medical scandal because placebos can actually have a healing effect. For this reason, the Medical Association recommends that physicians increasingly resort to apparent medicines, alleged therapeutic treatment methods and ineffective injections in the future. A so-called placebo effect has already been demonstrated in several studies. The positive thing about this is that the products are free of medical ingredients, but there are no health-damaging side effects to worry about. In addition, expenditure in the health care system is reduced and positive results can nevertheless be achieved.
Studies prove medicinal effects of sham agents "Their use is of enormous importance for medical practice," said Prof. Dr. Christoph Fuchs, General Manager of the German Medical Association (BÄK), at the presentation of the now available in book form by the BÄK Scientific Advisory Board "Placebo in Medicine". Because researchers can even demonstrate the effects of pseudo drugs in the brain. A large number of studies suggest that the activation of the frontal lobes in particular can explain the effect of the effect. Prof. med. Robert Jütte, who is also head of the Institute for the History of Medicine at the Robert Bosch Stiftung, emphasized that placebos played a central role not only in clinical research as a control group, but also in the effective treatment of diseases. Accordingly, the remedies are no mere imagination, since an effect is actually set in motion clinically. To date, scientists have no understandable explanation for this effect. One guess is that an effect depends on the patient's expectations or learning experience. Many people assume that "if I take a remedy, the pain will go away". Or they have already had a positive experience and the organism now starts from a healing process and starts immunizing or analgesic effects. The study author Jütte said that recent studies had even found that sham medications have even better chances of being cured if the doctor treating them praised the medication as "expensive".
Placebo and ethical principle However, the question remains in which patient cases the use of a placebo corresponds to the ethical principles of medical therapy. The report “Placebo in Medicine” wants to answer exactly that question. Administration is not possible, for example, at the moment when a doctor withholds an actually effective medication from his patient or when the ill state of health of the patient deteriorates due to the administration of the sham. A doctor must also always inform about possible risks and side effects. This also applies if the remedy is actually a sham drug. But do the sham preparations still work if the patient knew about them? Yes, says Jütte. According to the scientist, further studies would have shown that placebos also work if the person concerned knows that the drug actually does not contain any active pharmaceutical ingredient. Because placebos work without deception.
The Chairman of the Scientific Advisory Board of the German Medical Association, Prof. Peter Scriba, explained in the foreword to the publication that the study considers both areas of the use of placebo, clinical studies and therapeutic practice, equally. Last but not least, the ethical problem, but also the less well-known legal framework, will be discussed in detail. "This is particularly true with regard to a special group, those who are unable to give their consent, for whom little has so far been found in the literature on placebo," emphasized Scriba. Overall, the use of placebos in medicine is quite desirable. Because "using placebos can maximize the desired drug effects, reduce the undesirable effects of drugs and save costs in the health care system."
88 percent of Bavarian doctors use sham medication During the presentation of the new report in Berlin, the author referred to a survey among general practitioners in Bavaria. 88 percent of general practitioners said they had already used a placebo. Around 72 percent of Swiss medical colleagues said in a survey that they used a placebo in everyday practice. Jütte concludes that in Germany "over 50 percent of doctors use it in therapeutic practice".
What is in placebos? In practice, vitamin preparations or sham acupunctures are mostly used. Other doctors have formed an “alliance” with pharmacists who then issue colored sugar pills on prescription. Sometimes it happens that the doctor puts an injection without active ingredients. In rare cases, so-called sham operations are even undertaken. In other words, no surgery is actually carried out during the operation.
Deception or healing But do patients now have to suspect that their doctors are not taking them seriously or are treating them incorrectly? What initially feels like a deception helps in many cases. According to Prof. Jütte achieve a healing effect in stomach ulcers in 59 percent of cases. Very good results have also been observed with mental disorders. Placebos sometimes work just as well as strong psychotropic drugs, which sometimes have strong side effects. The expertise "Placebo in medicine" (ISBN 978-3-7691-3491-9), published by the German Medical Association on the recommendation of its Scientific Advisory Board, can be obtained from the German Medical Association. (sb)
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