>Otherwise every single pharmaceutical trial would be impossible since "we can't knowingly give humans a placebo"
Lots pharma trials are against current best standard of care and not placebo. Placebo trials are never done in cases where effective therapy is available.
>A: Placebo-controlled trials are never appropriate when a highly effective or potentially curative therapy is available for a patient. An exception is unless the trial allows the patient to receive the new treatment/placebo in addition to the potentially curative therapy. For example, let’s say that a promising new treatment is in development for advanced testicular cancer, a disease that is curable in many cases with the use of chemotherapy. It would not be appropriate for a clinical trial to randomize patients between the new treatment and placebo because potentially curative chemotherapy already exists. However, it might be appropriate to randomize between standard chemotherapy plus the new drug or standard chemotherapy plus placebo because in both cases, patients will receive the standard, potentially curative treatment.
"29. The benefits, risks, burdens and effectiveness of a new method should be tested against those of the best current prophylactic, diagnostic, and therapeutic methods. This does not exclude the use of placebo, or no treatment, in studies where no proven prophylactic, diagnostic or therapeutic method exists."
This was the biggest event of the last 50 years, we can throw a few billion at a real trial.