The placebo effect is a very interesting bane in scientific research. It cannot be easily dismissed, nor can it be readily explained. Yet it is a factor in clinical research, and scientists must deal with it scientifically as an abnormality. The real question is the placebo the only actionable method of action at work, or is the procedure, drug or chemical being tested (the alternative hypothesis) actually “doing something”. Should we have research that accepts where the placebo is scientifically effective, and where it isn’t?
Scientists rarely study the placebo effect, because it can be problematic to isolate variables. In addition, allopathic medicine tends to think of the placebo effect as a negative factor. Researchers and doctors could accept it as a viable and ethical factor to healing if fully disclosed. That is to say is there enough evidence to warrant using the good side of the placebo, scientifically, to improve the quality of care and treatment?
Placebo effects have been shown to be less of a factor in some disease states such as cancer (Chvetzoff & Tannock, 2003) or infection, and more of a factor in things like pain management (Hunter, 2007). If the placebo effect is a tool for healing, is there justification to use it when it has been proven to work?
One of the most profound discoveries on the strength of the placebo effect was a study using Novocaine from dentists (citation pending). These dentists were given a placebo and told to administer it as Novocaine to their patients. Even though the doctors didn’t do anything different in administering the placebo the effect the placebo was, as you would expect, very low. However, when the doctors were given blinded placebo, not knowing if they were giving real Novocaine or the placebo, the placebo rates went up statistically higher. Somehow, patients felt that they were getting the real thing, and the only change was the doctors were blinded. But the most profound aspect of this study came from looking at the doctors were all given a placebo, and told it was real Novocaine. The rate of agonistic effect was very high. In other words, for some reason, doctors were able to transfer the belief that the treatment would reduce pain. If they believed it, so did their patients.
Is it possible then to realize that there is value in the placebo effect? Should “above the board” disclosure include the use of clinical situations that contribute to areas where a placebo effect is a part of the treatment? Where do we draw the line, when the placebo effect should be used, or when it shouldn’t be used. Clearly patients expect the cost of their medication or treatment should be above and beyond the value of the placebo. Scientist are now starting to explore the ethical use of the placebo.
Chvetzoff, G., & Tannock, I. F. (2003). Placebo effects in oncology. Journal of the National Cancer Institute, 95(1), 19-29.
Hunter, P. (2007). A question of faith. EMBO reports, 8(2), 125-128.