Study: Placebos Can Work Even if Patients Know They're Placebos

By Andrew Moseman | December 27, 2010 9:56 am

You’ve heard of the placebo effect—the tendency for patients who receive a phony treatment like a sugar pill to feel better just because they think the treatment will help them. That standard definition relies on deception. Surely the placebo effect doesn’t work if you tell the patients they’re taking placebos, right?

Not necessarily, a new study finds. And, as DISCOVER blogger Ed Yong notes, this brings up an interesting ethical question:

Can doctors justifiably prescribe placebos to their patients? The standard answer is no. Doing so patronises the patient, undermines their trust, and violates the principles of informed consent. It compromises the relationship between doctor and patient. At worst, it could do harm.

But many of these arguments are based on the idea that placebo effects depend on belief; people must expect that treatments will work in order to experience any benefits. For a doctor to prescribe a placebo, they’d need to deceive. But according to Ted Kaptchuk from Harvard Medical School, deception may not be necessary. In a clinical trial, he found that patients with irritable bowel syndrome (IBS) felt that their symptoms improved when they took placebo pills, even if they were told that the pills were inactive.

For plenty more about this, check out the rest of Ed’s post at Not Exactly Rocket Science.

Related Content:
Not Exactly Rocket Science: The Placebo Effect Affects Pain Signaling in the Spine
Not Exactly Rocket Science: A Biological Basis for Acupuncture, or More Evidence for a Placebo Effect?
80beats: 50% of U.S. Doctors Secretly Dose Their Patients—With the Placebo Effect
DISCOVER: Is the Placebo Effect a Myth?

Image: flickr/Fillmore Photography

CATEGORIZED UNDER: Health & Medicine
  • Chris Caprette

    Please read Orac’s takedown of this study at Respectful Insolence. The study was rather seriously flawed.

  • Marc

    Orac’s take is at http://www.sciencebasedmedicine.org/?p=9339. Highly recommended. In particular, note that although the researchers told the patients that the placebos were inert, they also followed a script designed to make that description meaningless in terms of generating a placebo effect:

    “The provider clearly explained that the placebo pill was an inactive (i.e., “inert”) substance like a sugar pill that contained no medication and then explained in an approximately fifteen minute a priori script the following “four discussion points:” 1) the placebo effect is powerful, 2) the body can automatically respond to taking placebo pills like Pavlov’s dogs who salivated when they heard a bell, 3) a positive attitude helps but is not necessary, and 4) taking the pills faithfully is critical. ”

    So you tell the patient it is a sugar pill in 30 seconds, then spend 15 minutes convincing him that placebos are really significant and powerful medicine and taking them is critical to them getting benefit, and then you’re shocked that you have a moderate result of benefit? Sounds like some of the people being fooled some of the time to me.

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