The Placebo Effect : History, Biology, And Ethics

Placebos have been used in clinical trials since the eighteenth century but did not become a research topic until the late twentieth century (van Haselen, 2013). Most often when using placebos in clinical trials it is to determine whether or not the active agent has more effect on a patient than the placebo by providing each to the same number of recipients. The trials are almost always double blinded, this means that both person giving the drug and the person receiving it are unaware whether or not it is active so that good care and relationships must be present in the recipients at all times (Tavel, 2014). Ovosi, Ibrahim, & Bello-Ovosi (2017) declared “The choice between placebo and active controls in clinical trials affects the quality of the result as well as the ethical and scientific acceptability by both the public and regulatory bodies. It has, therefore, continued to generate discuss among researchers” (para. 3). This goes against the autonomy of a patient which is the right for a person to

Imagine going to the doctor and being given medication to heal your pain. Now how would you feel if after taking the medication and feeling better you came to find out you were given a placebo? This may sound upsetting to some, however, “ a recent survey of U.S. internists and rheumatologists found that some 50% regular prescribe placebos.” A placebo is defined as a false treatment without any significant chemical properties or active ingredient. The use of placebos as a primary form of treatment with any pathology is not happening anytime soon, but their positive impact and usefulness in the medical field is becoming hard to deny. In the article, “The Magic of the Placebo”, author David Bjerklie attempts to explain the growing change in

The study subjects were gathered from various ICU centers at various institutions, which is appropriate for study given the study objective and what the study was aiming to examine and determine (using a study drug vs. placebo in an ICU environment). Inclusion criteria were appropriate to assess the effects of the anti-pyretic acetaminophen due to their specificity of including those patients who were febrile with an infection that had been initiated with antimicrobial therapy. The exclusion criteria was extensive and included patient characteristics and disease states that may have skewed the true effect of acetaminophen. It was appropriate to limit these patients with the exclusion criteria from receiving treatment since their comorbidities

While noting that the ethical issue of deception exists, the significant benefits of placebos are revealed through studying some clinical cases and by determining the actual changes taking place in the brain and the body. Trust, found in the doctor-patient relationship, impacts the extent of the placebo effect. To possibly help solve the ethical issue of deception surrounding around the placebo effect, Kaptchuk points out that more research needs to be executed in order to carry out the placebo effect “with conformed consent” of the patient for the doctor to do what they believe is necessary for the patient’s well-being (9). This would eliminate the ethical issue of deception while still allowing “medicine’s goal to heal” to remain intact

“The power of placebos has been recognised for improving numerous medical conditions”(Fernandez 2001). However, there is still much speculation as to how the underlying mechanisms of an inert substance manage to instantiate that improvement. To better understand the role of placebos in treatment, a 2001 study of the placebo effect on Parkinson’s disease was conducted.

This is strong, clear and very persuasive evidence that Kennedy was speaking of an outcome that had been totally generated by a subject's negative expectation of a drug or ritual's administration, which was the exact counterpart of a placebo response that would have been generated by a subject's positive expectation.

A neurologist by the name of Michael Persinger and his colleagues received a particularly bizarre case “of a teenage girl who said she'd been impregnated by the Holy Spirit and felt the invisible presence of a baby on her left shoulder.” After thorough research, they were able to narrow down the cause of this eccentric occurrence to alarm clock next to her bed which was steadily generating magnetic pulses which could be compared to “those used to trigger seizures in epileptic rats.” Strangely enough, after the removal of the alarm clock all feelings of the presence

“Placebo effect is the term applied by medical science to the therapeutical and healing effects of inert medicines and/or ritualistic or faith healing manipulations. [1] [2]. When referring to medicines, placebo is a preparation which is pharmacologically inert but which may have a therapeutical effect based solely on the power of suggestion. It may be administered in any of the ways in which pharmaceutical products are administered.[3]

Placebos have been used throughout many studies when testing experimental drugs for certain medical conditions. A placebo is a form of treatment that, in a sense, has nothing in it. Patients in clinical drug trials are often enrolled in the trial because many other treatment options have been tried and have failed. For terminal patients these trials are often their last hope of recovering from their diseases. According to Millum et al. (2013), “To be ethical, clinical research requires balancing rigorous science with the protection of human subjects”. It is common for placebos to only be effective in pain- related cases since pain is a mental state and placebos work on the mind. In other cases, patients are administered a placebo when the real medication is unavailable and deceived into thinking they have a chance at getting better. Many nursing professionals do not agree with placebos since often they are the ones administering and interacting with the patients they hope to help. Placebos are only justified in pain related trials, unethical to be used on terminally ill patients, and can potentially cause negative health effects.

In the figure above, the proposed mechanism of dopamine (DA) as a placebo mediator is illustrated. After a placebo has been provided to a patient, DA neurons in the ventral tegmental area (VTA) are activated, which leads to the release of DA in the ventral striatum (nucleus accumbens, NAcc) and in the prefrontal cortex (PFC). Consequently, the PFC activates disease-specific mechanisms, such as opioids for placebo analgesia, dopamine for motor improvement in patients suffering from Parkinson’s disease, and perhaps serotonin (5-HT), which relieves depressive symptoms.

Placebo should be administered. It’s been proven that the positive thinkers normally respond to it quite well. Many of us have had the “oh, it’s all in my head” ailment, but you just can’t seem to beat it. That’s where placebo comes in to assist. Since it’s an inert substance, one shouldn’t experience any of those unpleasant side effects unless they expect them. Those not all for placebo would go with the fact that not everyone can’t have the right mindset, but that’s only if the patient were to be completely negative about their treatment. If the patient was thinking that nothing could cure them, then no medication will do its job thoroughly and correctly. During the diagnosis, if it’s a single blind study, (only the doctor knows about the placebo) the doctor would call the placebo a regular drug used to treat the ailment and reassure the patient of its effectiveness. Confirmed by Dr. Walter A. Brown, placebos are efficient in treating mental disorders like anxiety and

The placebo effect is well documented in reducing pain, depression, and anxiety. The response from a placebo can be positive or negative. The person’s symptoms could improve, or the person may appear to have side effects from the treatment. But how does the Placebo Effect work? One of the most common theories is that the placebo effect is due to one’s expectations. If an individual expects a pill to do something, it is possible that the body’s chemistry can cause effects that are similar to the effects of medication. The placebo effect is used practically every single day. When I am at the gym lifting weights, I struggle without having a spotter. But as soon as someone is spotting me and touches the bar in any form, I suddenly do much better.

Placebo treatments in the use of medicine have always sparked debates on ethics and acceptability. But personally, yes, I believe in placebo. I I have heard so many friends who got better without the use of medicine. The healing process can be attributed to the mind's willpower. As has been said, the mind controls the body. So if you put your mind to work to believe in something, it can do many great things like making you feel better physically. With this, placebo could actually work especially in this day and age where people are most often self-diagnosing themselves. In fact, television advertisements on prescription medicines that promise to relieve pain automatically send signals to viewers that they need these drugs and that they

Researches on placebo effect in the 1970s showed that placebo analgesia is initiated by production of endogenous opioids (Benedetti, 2009)

The placebo effect is often thought of as an act of fooling the mind into perceiving a benefit that has no physical basis. This depiction of the mind as a naïve and foolish organ may be incomplete and ill-representative of the mind's abilities. Indeed, the mind may orchestrate a physical response in the body based on its