If a placebo has a positive effect on the patient, but to get that effect, the patient must be deceived, is the placebo ok to use? Some argue that prescribing a placebo is fake medicine. And yet, ibuprofen cannot be tested in the United States because the belief that Ibuprofen works makes it 60% more effective. In addition, pain killers are not as effective if infused secretly, instead they work better if the patient knows they are receiving the drug. The ethical questions surrounding placebos can be summarized in two arguments: that placebos should not be used because it is deceptive, and that placebos should be used because the healing effect is real. Unfortunately, the power of the placebo can easily be exploited by businesses claiming that their supplement works, and in many cases the only thing that contains the supplement is the label. Consider this research from Newmaster et al., 2013 on the contents of 44 different herbal supplements. They found that product substitution occurred in 30/44 of the products tested, in other words, the actual herbal supplement was not found in the product. In addition, most of the herbal products tested were of poor quality, contained a considerable amount of substitution and contamination. Many of the contaminants found posed serious health risks to consumers.