Fundamentals of Nursing Q 492
The physician has ordered a placebo for a chronic pain client. You are a newly hired nurse and you feel very uncomfortable administering the medication. What is the first action that you should take?
A. Prepare the medication and hand it to the physician.
B. Check the hospital policy regarding the use of the placebo.
C. Follow a personal code of ethics and refuse to give it.
D. Contact the charge nurse for advice.
Correct Answer: D. Contact the charge nurse for advice.
A charge nurse is a resource person who can help locate and review the policy. If the physician is insistent, he or she could give the placebo personally, but delaying the administration does not endanger the health or safety of the client.
Option A: In a treatment setting it is unethical to deliberately misinform the patient. However, placebo effects can be an important factor in a biopsychosocial context. Clinicians need to consider some ethical issues relating to placebo effects. According to Pittrof and Rubenstein, the ethical use of placebo effects should always benefit the patient and involve disclosure.
Option B: Placebo effects may thus be defined as psychological and/or physiological responses that follow the administration of active and non-active substances when coupled with an affirmation of the treatment effects. The ethical use of placebo effects in a clinical setting should rely on realistic expectations and be based on best practice. The use of a placebo in clinical settings might still be seen as controversial by some.
Option C: While following one’s own ethical code is correct, you must ensure that the client is not abandoned and that care continues. Placebo effects, when considered as supplements to pharmacologically active substances, should aim to increase patients’ well-being. It is unethical to deliberately misinform patients.