Surgical Placebo in Jewish Law
o the study had their chest cavity opened without any proce-dure actually perormed. Questions concerning the ethics o perorming such an invasive surgery without perorming thebenefcial technique arose as a result o this attempt to producea scientifcally sound experiment.Nearly our decades later, another surgical placebo trial was conducted using etal niagrostriatal dopaminergic neuronsgrated into the brains o patients suering rom Parkinson’sdisease.
Similar to the dramatic and invasive nature o thearterial ligation, the placebo-controlled patients were anesthe-tized and a burr-hole procedure
was perormed, without any additional invasive technique. In ollow-up, these placebo pa-tients were given the same medical treatments that their treatedcounterparts received, including a dose o Cyclosporin. A surgical placebo trial in 2002 ollowed a less severeprotocol. Arthroscopy and debridement had become the stan-dard treatment or osteoarthritis in the knees.
Moseley et alconducted a randomized double-blinded case-controlled study, with the placebo patients receiving modifed sedation and a ew incisions and closures in the knee. A unique eature o thistrial was the inormed consent process, wherein the patient wasasked to write a description o the placebo arm o the trial,indicating their explicit consent to that possibility.
In the latter two cases, controversy was sparked anew or a number o reasons, primarily because in the last two de-
3 O. Lindvall, G. Sawle, H. Widner, et al., “Evidence or long term survivaland unction o dopaminergic grats in progressive Parkinson’s disease,”
An-nals of Neurology
35 (1994): 172-80.4 Essentially, a small hole was drilled into a bone in the skull, without pen-etrating entirely through.5 Osteoarthritis occurs due to the breakdown o cartilage in, and subsequentnarrowing o, joint spaces, producing pain on movement. Te standard o treatment is orally administered pain medications, specifcally NSAIDs, orsurgical arthroscopy o the knee, which entails debridement o the jointspace.6 J.B. Moseley, K. O’Malley, N.J. Petersen, et al, “A controlled trial o ar-throscopic surgery or osteoarthritis o the knee,”
New England Journal of Medicine
347 (2002): 81-8.