Mothers' Little Helpers?

By Randy Hendrickson

A New York Times article ( “Experts Question Placebo Pill for Children” --May 27, 2008) raises the question of whether giving children placebo pills for minor childhood illnesses is an ethical practice. Based on the premise that pharmacologically inert compounds can actually produce improvements in some medical conditions, Jennifer Buettner, a mother of three small children, developed a cherry-flavored chewable dextrose tablet, the first branded, pharmaceutical grade placebo. The therapeutic effect is based on the power of suggestion. Parents use the placebo to “trick” their children into thinking that they are taking real medicine, and the children will consequently feel better. The placebo, called Obecalp™ (placebo spelled backwards), goes on the market on June 1 and will be available in retail stores and on the Efficacy Brands website.

Several bioethicists speak out about the use of placebos in children:

Howard Brody, MD, PhD, a medical ethicist at the University of Texas Medical Branch at Galveston, claims that there is no way to predict the response of placebos, especially in children. There may be a dramatic response in some children, whereas others may have no response at all. “The idea that we can use a placebo as a general treatment method strikes me as inappropriate.”

Franklin G. Miller, PhD, a bioethicist for the National Institutes of Health, agrees. “As a parent of three now grown children, I can’t think of a single instance where I’d want to give a placebo.”

There is also the question of deception:

Steven Joffe, MD, MPH, a pediatrician and bioethicist at Dana-Farber Cancer Institute, does not condone parents purposefully lying to their children. “It makes me squeamish."

In addition, other physicians have expressed concern that giving children a pill for every minor ache or pain will lead children to believe that you can only get better by taking pills or medicine. They will not come to realize that most ailments will eventually resolve on their own. This pill-taking behavior can carry over into adulthood. In most cases, what children really need is a little comforting, nurturing, and attention, rather than fake pills.