Trends in ethical discussions on placebos for therapeutic purposes: A focus on discussions relating to nurses

Abstract

This literature review study aimed to provide basic data for nurses to understand issues in ethical discussions surrounding the use of placebos in nursing. A review of 13 English publications and 5 Japanese publications revealed 8 ethically negative reasons, such as invasion of patient autonomy, and 6 ethically positive reasons, such as the effects of placebos. Discussions in English publications were focused mainly on the perspective of ethical principles, and those in Japanese publications were focused mainly on the perspectives of the effects of placebo and care/virtue ethics. The following 6 reasons were, for the most part, absent from Japanese publications: appropriate evaluation of patients/invasion of a patient’s right to receive care, invasion of a patient’s dignity, arbitrary use by healthcare professionals, nocebo effect, skepticism toward the effects of placebos, and do not/cannot distinguish motives. Our findings suggest the need to provide nurses with opportunities to understand ethical discussions regarding the use of placebos from various perspectives, such as ethical principles and the ethics of care, without bias.