Placebos and treatment of pain.

A 52-year-old female patient, with a long history of chronic low back pain treated over time with various modalities including, recently, opioids, goes on Friday evening to the emergency room for, she says, “excruciating, paralyzing, back pain.” The house officer working her up finds that she just ran out of the pain medications she was previously on; his evaluation is totally negative; the patient requests IV meperidine for her pain. The house officer agrees verbally to the patient’s request, but, instead of injecting meperidine, gives her a 2-mL syringe of normal saline IV “to see if it will work.” Is this treatment acceptable?