Placebo: no relief for Ms. Mahoney's pain. Working with the patient, family, and staff to diminish pain

Is a placebo ever an appropriate therapeutic intervention? This month we examine that question, & others, in a trio of articles on the use of placebos. A case study. A nurse discovers deceptive placebo use in a nursing home. The author describes how he uncovered the practice & what it took to initiate change at the facility. Ethical Issues An essay from the column's coordinator considers the nurse's responsibilities & how deceptive practice affects patient care, as well as the appropriateness of placebo use in clinical practice. Pain Control. Addressing placebos & the treatment of pain, the authors assert that they should be used only in trials approved by an institutional review board. They also make arguments against the American Pain Society's position on the use of placebos in "N-of-1 trials," which are purported to "evaluate the effectiveness of a procedure or treatment in a single person.".