Exceptional lies: The ethics of deceptive placebos in clinical settings

In this article I explore the ethics of using deceptive placebos in clinical contexts. The view that I will defend is that there is no reason to regard the moral case for or against the use of deceptive placebo as different from other cases in which doctors confront moral dilemmas about the use of “paternalistic”, “therapeutic”, or “benevolent” deception. In particular, I will criticize two influential positions within the current placebo debate. The first position is the one according to which deceptive placebos do not raise substantial moral concerns because they can be administered in ways that are “not transparent” and yet “not deceptive”. The second position, then, is the one endorsed by the American Medical Association (AMA) according to which the use of deceptive placebos without patients’ consent must be categorically prohibited. In this article I argue that both views are flawed because they equally misrepresent key aspects of the morality of benevolent deception in clinical settings.