Acupuncture: Is It Ethical to Give a Combat Soldier a Placebo for Pain?

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From a security standpoint, the only thing that matters is that our soldiers are effective at killing people and breaking things. Does acupuncture help accomplish that? We presented one opinion last week. Now, here's a second viewpoint on the matter.

Without a doubt, almost all alternative medicine is junk science. That would include widespread practices like acupuncture, which the biomedical literature has shown convincingly confers no real medical benefits compared to placebo.

But the placebo effect is powerful. It is far more than the "power of positive thinking." Instead, the placebo effect has real, measurable effects on the human body. Therefore, even if a "treatment" is nothing more than a placebo, some people undoubtedly will benefit from using it.

However, that raises a serious ethical question: Should a doctor prescribe a treatment to a patient that has no evidentiary support but might benefit the patient via the placebo effect? Unlike most scientific "debates" in the media, there are two diametrically opposed -- but perhaps equally legitimate -- schools of thought on this.

The first is, to put it crudely, "Hell, no." It is deeply unethical, the reasoning goes, to prescribe any treatment that doesn't work. Besides, there is a danger that this practice could encourage people to embrace phony medicine in the face of a debilitating or life-threatening illness. Doctors should not be in the business of peddling witchcraft.

The second is, "If it helps but doesn't harm the patient, why not?" Some medical conditions, most notoriously chronic pain, have a gigantic psychological component. If anything makes the patient feel better -- sugar pills, meditation, yoga -- then what's the harm in prescribing the patient a "treatment" that "works," only if it's in the eyes of the patient? The placebo effect is real, so doctors should harness it.

That debate serves as the background to a controversial decision to give acupuncture to combat soldiers.

Is It Ethical to Give a Combat Soldier a Placebo for Pain?

In a statement, the U.S. Military Health System announced that the Air Force is utilizing "battlefield acupuncture" to treat pain. One of the doctors who champions the practice said that acupuncture is "safe, easily teachable, and a highly effective treatment option."

As stated, that's not really accurate. Acupuncture can lead to infections, and it is easy to imagine that the risk of infection is worse in combat settings -- particularly if recently trained people are administering it. (His comment that acupuncture is "easily teachable" is rather concerning. Who would they be teaching to do this?) And, as stated above, there is no evidence that acupuncture is "highly effective," unless the doctor meant to say, "Acupuncture is a placebo, and placebos can be highly effective."

This debate gains an added layer of complexity because it involves soldiers, so deploying acupuncture in the field becomes a question of national interest. From a security standpoint, the only thing that matters is that our soldiers are effective at killing people and breaking things. Does acupuncture help accomplish that?

Possibly. If an athlete's donning of "lucky underwear" helps him prepare psychologically for the big game, then there seems to be little harm in allowing a soldier to undergo acupuncture if he thinks it will make him a better warrior. At the end of the day, we need a lethal fighting force, and if talismans, charm bracelets, and scented candles help further that cause, then so be it.