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[JSR] Are Placebos Clinically and Ethically Acceptable?

A placebo is by definition, “a harmless pill, medicine, or procedure prescribed more for the psychological benefit to the patient than for any physiological effect.” It is latin for “I shall please.” Whether it be sterile water, saline solution, or a sugar pill being handed to patient to make his illness magically go away, a placebo can seem to be a farce and a sham in the common eye.

However, in certain cases, it can also be somewhat of a miracle worker. Substantial effects have been documented in clinical trials and on conditions such as depression, pain, sleep disorders, irritable bowel syndrome, and menopause, even though placebos have no inherent potency. Why have placebos been effective in reducing the symptoms of such conditions?

For one, when a patient expects a pill to help treat a condition, his body chemistry may actually reflect what the he thinks the pill is doing. Often, the patient receiving the treatment does not know that it is not real, but rather a placebo. A person who is made to trust that something is being done to help him/her is able to feel a sense of security, and this feeling allows him to re-evaluate the degree of his symptoms in a way that benefits his psyche.

An everyday example would be when a kid is crying over a small cut on his knee and then suddenly feels a bit better when his caretaker puts Neosporin and a Band-aid over it. Although the two items do not have any direct pain-relieving properties and cannot make the cut go away instantly, the kid stops crying because he is given the attention he needs and the reassurance that everything will be okay. The ritual of tending to the boy’s wound, the kind words of encouragement and empathy, and the symbolism of the good old ointment and Band-aid combo is what stimulates positivity and hope.



The expectation for a treatment to have the desired side effects, in the context of a very serious medical condition, may cause a drop in a patient’s stress hormones, increase the levels of dopamine in the brain, or increase the circulation of endorphins in the body, all effects that are measurable physiological changes. The brain can experience illness differently than the body does, and placebos can only affect what the brain can modulate.

Placebos manipulate what the brain perceives; they don’t necessarily hit the root of the problem. For this reason, placebos are intended to complement real drugs when treating patients, not to replace them. They also help researchers isolate the side effects of real drugs they are testing in the lab. So, it isn’t about tricking people; it’s about changing lives for the better.


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