What matters is whether psychological satisfaction SHOULD be a consideration in administering treatment. But whether it currently “is” a consideration is not relevant to the argument. The author’s position is that it might not be an appropriate consideration, regardless of whether doctors in fact consider psychological satisfaction.

Necessary, because if it were not true — if the motivation for administering a placebo CANNOT be relevant to the ethical justification for the placebo — then the premise concerning the potential purpose of the placebo doesn’t provide support to a conclusion about the ethics of the placebo.

Not necessary, because the author’s conclusion is only that administering a placebo is ethically questionable — that doesn’t mean the author thinks it’s indefensible. There are questions raised about it, but that doesn’t mean it can’t be defended. Also, the argument doesn’t refer to cases in which treatment relies on the placebo effect “alone.”

Not necessary, because the author’s conclusion is that the placebo is ethically questionable. That doesn’t commit the author to thinking that placebos are justified.

Not necessary, because the author’s conclusion is that the placebo is ethically questionable. That doesn’t commit the author to thinking that placebos are definitely unjustified under certain circumstances.