By Polina Pallieraki,
A placebo is a medical treatment or procedure designed to “deceive” the person receiving it. It does not contain any active substance but seems to have a natural effect on the person. Usually, a placebo is used in clinical drug testing studies. In fact, for a new drug to be approved by the Food and Drug Administration, it must be shown to be more effective than a placebo.
The term “placebo effect” is used to describe the psychological or physical effect a placebo has on the person to whom it is administered. The most common application of placebo is in medical clinical drug testing studies. Participants are divided into three groups: those receiving the real drug, those receiving no medication at all, and those receiving a placebo. It has been shown that taking an empty tablet with no active substance, such as a simple sugar pill, is enough to cause a physical effect on the participant. The effectiveness of a placebo is affected by many factors. For example, injectable “drugs” cause a stronger reaction than tablets, while the effectiveness of the tablet varies according to its color and size. Placebo drugs cause measurable changes in the body, such as an increase in heart rate or blood pressure. However, conditions that require the patient to self-report symptoms appear to be more affected by the placebo effect. These conditions include, among others, depression, anxiety disorder, irritable bowel syndrome, and chronic pain. Placebo drugs, moreover, are known to reduce the symptoms of diseases such as Parkinson’s disease.
How does the placebo effect work?
Placebo drugs have a different effect from person to person, depending on the disease they are dealing with. How a placebo produces physical or psychological responses is not yet fully understood, so it is speculated that more than one mechanism exists. Below, we will look at some of the most common.
Anticipation and preparation
The effectiveness of the placebo is partly based on the expectations of the person taking it. This expectation can lower levels of stress hormones and cause the person to reassess the severity of their symptoms. For example, sharp pain after the administration of a placebo may be treated as simple tingling. On the other hand, if the person receiving the drug expects that it will not affect their body or cause unwanted side effects, it is possible that the placebo will cause negative effects.
Nocebo effect
A branch of placebo is the concept of nocebo. The etymology of the word nocebo comes from the verb to harm, which means that in the state of nocebo, the patient’s symptoms worsen unjustifiably when he distrusts an equally virtual and inert treatment.
Is the use of placebos ethical?
The introduction of placebos into medicine raises several questions about their ethics. Although they are based on the doctor deceiving the patient, if they have the desired effect, they should be considered an effective treatment. However, the use of placebos seems to pave the way not only for new fields of research but also for the relief of symptoms from a variety of ailments.
As conclusion of the above, in my opinion, we could say that, when there is no serious harm to the patient, then the use of the placebo effect can be considered as an ethical action. However, its use may be inappropriate, when there is already available treatment, that is known to prevent serious harm, such as death or irreversible morbidity in the population under examination.
References
- The placebo effect: Όλα όσα πρέπει να γνωρίζετε, wikihealth. Available here
- The power of the placebo effect, Havrvard Health Publishing. Available here
- Τι είναι placebo – πλασέμπο, Ελληνική Εταιρεία ομοιοπαθητικής Ιατρικής. Available here
