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Now a days medical world getting advance more and more for the diagnosis and treatment modalities of varies disease. They are also focusing on psychotherapy for the positive outcome. As I have observed in hospital setting that placebo was very ordinary practice, doctors and nurses were frequently using placebo in order to relieve patient’s pain but for me it was conflict thought that it should be used or not? It is also one of the controversial issues in medical profession. According to (literature) “placebo is a “sham drug” without any pharmacologically active substance, which is externally indistinguishable from the true drug (“verum”). Truly said by the author that placebo is not a right practice to which paramedical staffs are using now a day. By supporting the above content, bishop (2012) state that “placebo is a “dummy treatment”, which looks like the genuine medicine but contains no active ingredient.” I agree with that author is clearly indicated about placebo, it is not a true treatment, don’t have any actual pharmacological substance that can affect disease or symptoms, it is the kind of deceitful treatment. Sometimes it has been observed that placebo is effective treatment for the patient. However, in clinical setting this treatment is not always beneficial for the patient. Therefore, it should not be used for the patient because it has adverse nocebo effects that are harmful for the patient, and it also includes against code of ethics and will disturb neurotransmitters of the brain.
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During my job experience, I was working as a registered nurse in medical ward at AKUH; I have observed that placebo was very commonly used in order to reduce patient pain. It was variance thoughts for me that it should be used or not? When I encountered to 40years old women, she was suffering from severe pain and medical team administered placebo to her. Later on she developed placebo adverse effect that is vomiting, severe headache and high blood pressure and end up on unconsciousness. Above case study illustrate that placebo has harmful result that includes chemical changes in patient brain, withdrawal symptoms and also it has impact the trust relationship between health care team member and patient.
The first and most important reason is why placebo should not be used for patient is that placebo is harmful for patient’s health because it has adverse nocebo effect. According to (Finnes 2010) neurobiology of placebo effects is usually considered in terms of opioid and non-opioid mechanisms.
Author is clearly indicated that placebo alter patients body system, I totally agree with author that placebo makes chemical changes in patients body and these chemical changes will affect body mechanism that includes neurological, cardiovascular, physiological. Thus refrying to above mention case study, patient exhibit adverse effects of placebo and the end result is patients in life threatening condition. Another adverse effect of placebo is when patient discontinues taking placebo medications then most of the patients suffer from withdrawal symptoms. These are also hazardous for patient health as well.
The second reason of my propensity is that, as many codes of ethics support the notion that placebo is unethical practice and should not be done on patient and it is morally wrong. According to my personal experience that Health care worker were misleading the patient by giving placebo, also doing mistrust with them. Once, patient came to know about this malpractice then it will break trust worthy relationship among patient and health care workers. It will also break reputation with the patient and profession as well. According to (Miller,F,2009) “Deliberate misinformation or lack of transparency in describing placebo treatments to patients violate the principle of respect for patient autonomy and contravene the legal and ethical requirement to obtain informed consent. Moreover, it has mentioned in hospital policy that patient should have information regarding their own procedure and treatment. According to (Bishop 2012) “There is a clear ethical need for greater transparency and greater respect for persons in the provision of written information about placebo “in my opinion, doctors and nurses must have to give perfect information about placebo, its advantage and disadvantages then patient has a right to refuse or agree to receive treatment.
The third reason why placebo should not be used is that it interrupts brains neurotransmittres. This interruption cause chemical destruction in patient’s brain and leads to brain damage. As it has mention in above case study that instead of relieving patient pain, doctors and nurses put patient life in danger because placebo destruct neurotransmitters in patient brain and the result of this destruction, patient became unconscious. Furthermore, patient’s life is on risk. According to (pittrof, R2008) State that “side effects occur with placebo treatment, serious side effects (such as teratogenicity or death from overdose) of the type that occur with drug treatments must be extremely rare.”
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However, some health care workers state that placebo having positive outcome in order to relieve pain in panic condition which means it is beneficial for the patient. In addition to this, Placebo helps the doctor to treat patient with less harm, and several people state that doctors have a right to take a decision on behalf of the patient to regulate the placebo. Moreover, some people believe that placebo altered the brain neurotransmitters that results positive effects and provide the relaxation to the patient mind and also effective for the depression as well.
Although placebo has few positive effects but most of the time it has negative effects which can cause obstruction in the patient life. In addition to this, Sometime doctors have a right to take a decision on behalf of the patient but they don’t have to deceive patient by giving placebo. Furthermore, Placebo is not appropriate treatment for patient and it should not be continue because it destroys neurotransmitters in the brain.
In conclusion, placebo has adverse nocebo effect that is harmful for patient life, as in case study patient showed adverse nocebo effect. It is also against the code of ethics because patient doesn’t receive proper information about advantages and disadvantages of placebo. Moreover, placebo destruct brains neurotransmitters that will put patient life in threatening condition. As a nurse when I reflect back to my oath, it has clearly mentioned that nurses supposed to explain truth to the patient and explain about their treatment and procedure then patient has a right to decide either to receive or refuse. I strongly recommended that placebo should not be used in nursing profession because of its negative outcome on patient’s health. I also suggest that there should be strict policy in hospital setup that placebo should be prohibited. As a nurse I theoretical to tell truth to the patient in order to prevent from harm and maintain the discipline of my profession and satisfactory relationship between patient and nurse.
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