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• Beyond the half-truths about placebos and placebo effects
  Pekka Louhiala
  Published on: 27 March 2013

• Published on: 27 March 2013

  Beyond the half-truths about placebos and placebo effects

  • Pekka Louhiala, University lecturer
  • Other Contributors:
    • Raimo Puustinen

  We would like to thank Professor Stewart Justman for his thoughtful paper "Placebo: the lie that comes true", in which he highlights the often neglected deception in research on placebos and points out the potential harms related to half-truths or exaggerated claims about the "power of the placebo" (1). We agree strongly with his conclusion that "it is necessary to root the placebo effect in the attentive practice of me...

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  We would like to thank Professor Stewart Justman for his thoughtful paper "Placebo: the lie that comes true", in which he highlights the often neglected deception in research on placebos and points out the potential harms related to half-truths or exaggerated claims about the "power of the placebo" (1). We agree strongly with his conclusion that "it is necessary to root the placebo effect in the attentive practice of medicine itself". We also agree with his other conclusion that the "appropriate response to this dilemma is first of all to consider the placebo effect as a therapeutic benefit arising from the conscientious performance of the rituals of good medicine, and not as a resource to be tapped by the use of trickery (with equivocations counting as trickery) or dispensed in the form of pills."

  As Justman also remarks, much of the confusion related to placebos and placebo effects is related to the ambiguous nature and many understandings of these concepts. We'd like to develop this point further and repeat our earlier suggestion to replace the ambiguous "placebo effect" with a new term "care effect" in the clinical context (2). In the research context, the term "placebo effect" could be replaced by the expression "the effect in the control group" when the outcome of the research is discussed. The equivocal concept "impure placebo" confuses more than it clarifies and should be abandoned totally. If a method of treatment is ineffective in its own right, it should be called an ineffective treatment for a particular patient or problem.

  References: 1. Justman S. Placebo: the lie that comes true. J Med Ethics 2013;39:243- 248. 2. Louhiala P, Puustinen R. Rethinking the placebo effect. J Med Ethics; Medical Humanities 2008;34:107-109.

  Authors: Pekka Louhiala, Hjelt Institute, University of Helsinki, Finland, pekka.louhiala@helsinki.fi Raimo Puustinen, Medical School, University of Tampere, Finland, raimo.puustinen@uta.fi

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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