A dose of doubt: a qualitative study on placebo regulations

IntroductionPlacebo use is common in primary care, yet ethical and legal concerns persist, and few qualitative studies have explored physicians’ views on placebo regulation.MethodsWe conducted semi-structured interviews with 10 primary care physicians from 2 German-speaking Swiss cantons to explore...

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Main Authors: Mélina Richard, Manuela Ganz, Bernice S. Elger, Jens Gaab
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1574022/full
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author Mélina Richard
Mélina Richard
Manuela Ganz
Bernice S. Elger
Bernice S. Elger
Jens Gaab
author_facet Mélina Richard
Mélina Richard
Manuela Ganz
Bernice S. Elger
Bernice S. Elger
Jens Gaab
author_sort Mélina Richard
collection DOAJ
description IntroductionPlacebo use is common in primary care, yet ethical and legal concerns persist, and few qualitative studies have explored physicians’ views on placebo regulation.MethodsWe conducted semi-structured interviews with 10 primary care physicians from 2 German-speaking Swiss cantons to explore their definitions of placebos, usage in clinical practice, knowledge of existing regulations, and attitudes toward potential regulatory frameworks. Participants were recruited from a publicly available physician registry, yielding a 4.9% response rate.ResultsParticipants consistently reported using at least impure placebos in their practice, while references to the use of pure placebos were relatively uncommon. A distinction between pure and impure placebos emerged, with the latter generally viewed as more ethically acceptable. Risk-benefit evaluation was emphasized as the primary justification for placebo use. Most participants had not actively sought legal information, and knowledge about current regulations varied considerably. While clear support for specific regulation was rare, most participants did not perceive it as necessary, often citing distrust in regulatory systems or concerns that formal rules could restrict therapeutic flexibility. Expert bodies such as the Swiss Medical Association were mentioned as potential sources of guidance.DiscussionThe findings highlight a practice-oriented, risk-benefit-driven approach to placebo use, shaped by skepticism toward regulation and limited legal awareness. Despite frequent use, physicians operate in a legally ambiguous space and express limited demand for regulatory clarity, suggesting a need for targeted professional discourse rather than strict formal regulation.
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spelling doaj-art-d7725319ae594e1a8dc7d419dfeeb9db2025-08-20T02:39:55ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15740221574022A dose of doubt: a qualitative study on placebo regulationsMélina Richard0Mélina Richard1Manuela Ganz2Bernice S. Elger3Bernice S. Elger4Jens Gaab5Institute for Biomedical Ethics, University of Basel, Basel, SwitzerlandDepartment of Biomedical Engineering, University of Basel, Basel, SwitzerlandDivision of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, SwitzerlandInstitute for Biomedical Ethics, University of Basel, Basel, SwitzerlandCenter for Legal Medicine, Faculty of Medicine, University of Geneva, Geneva, SwitzerlandDivision of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, Basel, SwitzerlandIntroductionPlacebo use is common in primary care, yet ethical and legal concerns persist, and few qualitative studies have explored physicians’ views on placebo regulation.MethodsWe conducted semi-structured interviews with 10 primary care physicians from 2 German-speaking Swiss cantons to explore their definitions of placebos, usage in clinical practice, knowledge of existing regulations, and attitudes toward potential regulatory frameworks. Participants were recruited from a publicly available physician registry, yielding a 4.9% response rate.ResultsParticipants consistently reported using at least impure placebos in their practice, while references to the use of pure placebos were relatively uncommon. A distinction between pure and impure placebos emerged, with the latter generally viewed as more ethically acceptable. Risk-benefit evaluation was emphasized as the primary justification for placebo use. Most participants had not actively sought legal information, and knowledge about current regulations varied considerably. While clear support for specific regulation was rare, most participants did not perceive it as necessary, often citing distrust in regulatory systems or concerns that formal rules could restrict therapeutic flexibility. Expert bodies such as the Swiss Medical Association were mentioned as potential sources of guidance.DiscussionThe findings highlight a practice-oriented, risk-benefit-driven approach to placebo use, shaped by skepticism toward regulation and limited legal awareness. Despite frequent use, physicians operate in a legally ambiguous space and express limited demand for regulatory clarity, suggesting a need for targeted professional discourse rather than strict formal regulation.https://www.frontiersin.org/articles/10.3389/fmed.2025.1574022/fullplacebo useprimary care physiciansclinical decision-makinghealthcare regulationmedical ethics
spellingShingle Mélina Richard
Mélina Richard
Manuela Ganz
Bernice S. Elger
Bernice S. Elger
Jens Gaab
A dose of doubt: a qualitative study on placebo regulations
Frontiers in Medicine
placebo use
primary care physicians
clinical decision-making
healthcare regulation
medical ethics
title A dose of doubt: a qualitative study on placebo regulations
title_full A dose of doubt: a qualitative study on placebo regulations
title_fullStr A dose of doubt: a qualitative study on placebo regulations
title_full_unstemmed A dose of doubt: a qualitative study on placebo regulations
title_short A dose of doubt: a qualitative study on placebo regulations
title_sort dose of doubt a qualitative study on placebo regulations
topic placebo use
primary care physicians
clinical decision-making
healthcare regulation
medical ethics
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1574022/full
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