2003/11/01 by Franklin G. Miller · 1 citation
Neuroscience · Medicine · Social Sciences · Psychology · #Pain Management and Placebo Effect #Orthopedic Surgery and Rehabilitation #Academic integrity and plagiarism #Sham surgery #Informed consent #Medicine #Clinical trial #Placebo #Knee surgery #Declaration of Helsinki #Ethical issues #Surgery #Psychology #Alternative medicine #Engineering ethics #Osteoarthritis #Pathology
paper · doi:10.1162/152651603322614580
openalex publication_date 2003/11/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
Surgical clinical trials have seldom used a "sham" or placebo surgical procedure as a control, owing to ethical concerns. Recently, several ethical commentators have argued that sham surgery is either inherently or presumptively unethical. In this article I contend that these arguments are mistaken and that there are no sound ethical reasons for an absolute prohibition of sham surgery in clinical trials. Reflecting on three cases of sham surgery, especially on the recently reported results of a sham-controlled trial of arthroscopic surgery for arthritis of the knee, I present an ethical analysis that focuses on the methodological rationale for use of sham surgery, risk-benefit assessment, and informed consent.