Yes I think we must do the very best we can do for our patients and that includes offering treatments based on the best evidence. So in the case of bells palsy we certainly shouldn't be abandoning them. However we as like many other therapy professions, are masters at fooling ourselves into thinking we are being effective when we aren't and in our folly we take our patients along with the ride. Patients have a right to know whether or not a treatment is likely to work and if the treatment is likely to work to what extent. And if I treatment has been demonstrated to be no better ran a placebo then we shouldn't hoodwink our patients into false claims.

Take a step back and think about it in relation to other practitioners. How would you feel if your dr prescribed a medication which was known to be useless and may even have some unintended ill effects? Or what about seeing a psychologist for a mental health problem who gives you therapy for several weeks that has shown to have no benefit for such a problem and charges you for the privilege? You wouldn't undergo an operation that is known to be ineffective just because there is nothing else available.

So taking patients fears and desperateness seriously is important and ethical. But offering them useless therapy just to allay these anxieties, particularly when you are taking their money or spending the public purse or where someone else misses out because you have tied up your time on offering ineffective treatment - we have to stop doing this.