Is Placebo Surgery Unethical?

Surgical procedures are often introduced into practice without rigorous evaluation. Moreover, clinical trials of surgery have seldom included placebo surgery as a control, owing to ethical concerns. In 1959, the Journal published the results of a placebo-controlled trial of ligation of the internal thoracic artery for the treatment of angina.1 In this issue of the Journal, Moseley et al. report on a placebo-controlled trial of arthroscopic surgery for osteoarthritis of the knee.2 In both studies, the surgical interventions were no more effective than placebo operations. A major difference between the use of placebo surgery 43 years ago and its use . . .