Placebos work, so how do we ethically use them?


Or maybe you’ve only been provided with fake studies to make you THINK placebos are working.


So how do we ethically use them?

It won’t be an issue. It’s going to work out better than you ever imagined. I’ve seen what’s coming, and everything is beautiful. Wait til you see what’s next.


There are people who pay good money for homeopathic remedies, so I’m of the opinion that placebos are already being used.

Also, when I feel a cold coming on, I take one of those fizzy vitamin “makes-your-cold-shorter” remedies. It makes me feel better, even while I’m convinced it’s the placebo effect. It’s one of the flavors of my childhood, probably, chewable vitamin C. This must be the “theater” mentioned in the article.

If Big Pharma finds out how to make a lot of money from placebos, they would be everywhere. Whether that would be ethical is an open question.


You beat me to it. The homeopaths are already on the case.

You use them in addition to other treatments, or by themselves when the other treatments are unavailable too risky. And make them prescription-only, because the act of getting them from a doctor increases their effectiveness, at least in our culture.

“Take this. It is a placebo. Placebos work even if you know they are a placebo.”


Placebos are used every time you take a real medication, paradoxically. A researcher might try to discover the effect of the drug alone, discounting any benefit which is due to the placebo effect. However since both work to treat the patient, they are both of use to the clinician.

If we ignore ethics, it seems then that clinicians should constantly talk up the value of any treatment plan. They should do their best to both treat, and convince the patient that the treatment is going to be effective. That way the clinician gets the most out of the placebo effect and the treatment.

The real challenge comes from the ethics. How do you have informed consent, if your doctor is constantly talking up the treatment picked out.


See the word “ethical” in the headline?

Personally I think all meds that end in “LOL” are placebos. I take metoprolol, and I believe it lowers my blood pressure simply because I believe it does. If I lost faith, I would be dead in a matter of minutes.

I’m still not convinced by the studies that say placebos work even when people know they’re placebos and understand what that means. For example, in the study described by the paper linked from the article, patients were told that "placebo pills, something like sugar pills, have been shown in rigorous clinical testing to produce significant mind-body self-healing processes.” But I think a lot of people would hear that sentence as just more medical-speak. This study is stronger than most because they asked afterward what patients thought was in the pills, and while the patients didn’t know, they did guess things like “sugar” and “flour”. But given how little trouble homeopaths have in convincing people that some particular water has special healing properties, I’m not convinced these subjects understood that the placebos were designed, and believed by the people administering them, to have no special properties at all.

The only real benefit that would come from doctor’s handing out placebos is that it might keep people from going to non-doctors to get them.

Much of this sounds like placebos are being used as a replacement for a good bedside manner.

Probably not a coincidence, LOL

Placebos DON’T work. The placebo ‘effect’ is the effect they have on clinical studies - they confound them. This is not an indication that they have a valid therapeutic effect, because they don’t. Whatever effect they have is temporary and non therapeutic.

The ‘power’ of the placebo is the ‘power’ of the witch doctor, the ‘power’ of the quack. To argue that they can be used ethically is nonsense and the opposite of ethical medicine.

Placebos work because placebos don’t mean what most people think they mean. Placebo effect is any effect that can not be accounted for by the thing you are measuring, most of the time the placebo effect is just because most medical conditions get better by themselves, if you are taking crayons up the nose for your cold and you get better, is that because you where going to get better anyway or because of the crayons up the nose.
The mind over body effect, is only usefully for subjective symptoms, how you feel, pain, etc., for back pain state of mind can account for 60% of the perceived pain, this makes sense since pain is the translation of electrical signals into an emotional state. The state of mind effect has very little if any effect on objective symptoms, no matter how positive you are, you can not increase your white blood cell count by will alone.

Why? If I can take a placebo and I can ACTUALLY feel better, which is an effect measured already in thousands of studies, isn’t that placebo actually effective?

Not exactly, take a look for example at the book Snake Oil Medicine - he talks about how things like acupuncture have been shown to actually reduce the experience of pain - for as long as the patient believes it to be effective and correlated to the theater that the acupuncturist puts into treatment - how serious she is, how caring, how apparently knowledgeable.

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