Placebo and deception
Any intervention that does not have a therapeutic effect is called a placebo or dummy. It can be not only pills and injections, but also medical procedures. Placebos are used in clinical trials to evaluate the effect of real treatment interventions.
Placebos can also be used in conventional, clinical, medicine. According to a Cochrane Fellowship review, it may be effective in treating pain. Scientists are investigating the effects of placebo on many diseases, including irritable bowel syndrome and Parkinson’s disease.
It is generally accepted that the placebo effect develops only when the person who took the pacifier considers it to be a real medicine. A new study has shown that this is not the case: in some diseases, the knowledgeable use of a placebo can have a therapeutic effect. That is, patients do not need to be “deceived”.
Prescribing a placebo with patient consent is ethically important. The fact is that its use without the knowledge of a person is considered unethical.
Placebo without cheating
The new study involved 262 people with severe or moderate irritable bowel syndrome (IBS). They were divided into three groups: the first received a placebo openly, the second received a placebo disguised as a drug, and the third did not receive any drugs.
People who received placebo openly were told that the pills had no pharmacological effect, but could improve their condition due to the placebo effect.
Six weeks after the start of the study, IBS symptoms in people who received the placebo improved significantly compared to those in the control group. But there was no difference between the two placebo groups – the degree of relief was about the same for people who received the placebo “sham” and those who received it openly. Significant symptom relief was seen in approximately 70% of participants who received any form of placebo and 54% of those who did not receive treatment.
“If the assumption that a placebo needs trickery to work is wrong, then many theories about how placebo works need to be changed,” said Ted J. Kaptchuk of Beth Israel Medical Center.
Previously, Kapchuk and colleagues have demonstrated that overt placebo administration can have an effect on IBS. The novelty of the latest study is that scientists have now compared the effect of two placebo regimens. Similar placebo studies have also been conducted in the past for lumbago and chronic low back pain.