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The use of placebos in randomized clinical trials.

Most discussions of the ethical problems presented by the use of placebos in randomized clinical trials focus on the problem of deception. As I shall demonstrate, this focus is misplaced; it reflects a lack of appreciation of the differences between placebo usage in medical practice and in randomized clinical trials. One class of placebo usage in randomized clinical trials presents peculiarly difficult ethical problems-that is, clinical trials in which placebo is compared with an active