Treating Childhood Ouchies with Placebos An enterprising mother has started a company to sell cherry-flavored sugar pills parents can use as placebos to "treat" children's minor aches and pains without real drugs. Family physician Doug Kamerow says the plan raises many ethical issues.

Treating Childhood Ouchies with Placebos

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A new pill is going on sale next week. It's being marketed for kids who need a bit more than a kiss to make an oww-ie go away. It's just a placebo, as today's New York Times reports. It's a sugar pill. This non-medication is called Obecalp - that is, placebo spelled backwards. It was thought up by a mother who lives in Maryland.

Commentator Douglas Kamerow, a family physician, is not a fan of this new product.

DOUGLAS KAMEROW: There are so many issues here, I don't know where to begin. But first, let me tell you a story about placebos from my medical internship.

It was at a big, urban, county hospital, which took care of a mainly indigent population. Our pharmacy stocked two special painkilling drugs, available by a doctor's prescription only. One came in a brilliant red capsule, and the other was deep purple. The interns were instructed that these pills were for people who abused pain medications, and they were to be dispensed with care and with a good story. It turned out that the red one was aspirin, and the purple one Tylenol, although you couldn't find these exact words anywhere on the labels. And sure enough, I had a number of patients who said to me that they had to have that red pill, or that purple one, that it was the only thing that took their pain away.

If it's ever ethical to use a placebo, and I'm not sure that it is, this is a good example of when it might be appropriate, helping someone with a chronic problem, using a real medicine, one that is not too dangerous and has some efficacy of its own, and not lying about what's in it.

Contrast this with today's story about the new children's sugar pill. First, who are we treating here, children or their parents? If placebos are to work, the patients need to believe in them. Are we going to deceive the parents, too, or is it just their job to deceive their children? And what will happen when the children grow up and find out that they were being sold a pill of goods, so to speak?

Second, what are we teaching the children? That pills are the answer for all our aches and pains? And perhaps all our other problems, too? Not advisable. Third, what makes us think that kids want medicine? If all children are like my three kids, who are now all teenagers, they won't take medicine when they're little, and they don't want it when they're big, either.

And I don't buy the argument that a placebo pill is just like putting a Band-Aid on a boo-boo. We know it doesn't make any difference, but we tell the kids it does. Sure, there are kids who end up wanting a Band-Aid for every possible problem, but I have never seen an adult Band-Aid addict. I have seen lots of adults who want a pill for every ill.

When I told my wife about this new sugar pill for children, her concise response was, that's sick. And while I might not go that far, I do think that this is a deeply bad idea, however well-intentioned. Kids who are in pain or sick, but don't require real medicine, need someone to give them a hug, or a kiss, or if a treat is indicated, maybe a lollipop. But they don't need a sugar pill, and they certainly don't need to be deceived into thinking that it's the pill's magic, not mom's or dad's, that helped them feel better.

ADAMS: Family physician Douglas Kamerow is a former assistant surgeon general.

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