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To the Editor: Dr Miller and colleagues¹ concluded that CAM has no scientifically proven effects and thus argued that it cannot be used as a placebo treatment. I would go a step further and suggest that placebo should not be used to treat patients in any form. The use of placebo always requires some form of lying to the patients, which is both ethically and logistically problematic.

Furthermore, placebo response may not be predictable in individual patients, and thus there is little rational basis on which to prescribe it in general.

Matko Marusic, MD, PhD
mmarusic@mef.hr
Zagreb University School of Medicine
Zagreb, Croatia

1. Miller FG, Emanuel EJ, Rosenstein DL, Straus SE. Ethical issues concerning research in complementary and alternative medicine. JAMA. 2004;291:599-604. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:2193.

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