Placebo-controlled trials are used widely in the development of new pharmaceuticals. The concerns about the use of placebo-controlled trials are not uniformly unethical when known effective therapies are available, rather their approval is determined by whether the patient will be harmed by the extension of therapy. In my opinion, if patients are not harmed, then such trials can ethically be carried out. However, placebo-controlled is not acceptable or say unethical when patients are being treated with an existing therapy. In the end, it is upon the patient to make a decision whether they are ready to be involved in trials.