In many medical studies, even people who take “fake” treatments, such as sugar pills with no active ingredients, can still feel better. These are the puzzling “placebo effects”. They are common, diverse and powerful and they raise 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.
Fabrizio Benedetti, a placebo researcher at Turin Medical School who wasn’t involved in the study, says, “Although several studies suggested that placebos can be equally effective without deception, this is the first rigorous study that provides scientific evidence for this.”
Referring to an earlier study published in the British Medical Journal, he says, “We did the study because we knew that physicians were giving placebo to patients secretly without informed consent. Our study was designed to test whether placebo effects could be harnessed without this secret deception.”
The best poker players are masters of deception. They’re good at manipulating the actions of other players, while masking their own so that their lies become undetectable. But even the best deceivers have tells, and Meghana Bhatt from Baylor University has found some fascinating ones. By scanning the brains and studying the behaviour of volunteers playing a simple bargaining game, she has found different patterns of brain activity that correspond to different playing styles. These “neural signatures” separate the players who are adept at strategic deception from those who play more straightforwardly.
You’ll sometimes hear people lowering their voices to make themselves sound tougher or more commanding. We’re not the only ones – it seems that our close relatives, the orang-utans, pull the same trick, and they use tools to do it. Madeleine Hardus from the University of Utrecht has found preliminary evidence that young orang-utans use leaves for deception, in order to make lower-pitched calls that seem to come from a much larger animal.
While many animals are accomplished tool-users, most use their utensils to find food. A few populations of orang-utans, living in Borneo, are the only animals known to use tools to change the nature of their calls, much like humans use loudspeakers or microphones.
Their tools are leaves, and they’re used in the context of a specific call known as the kiss-squeak. It’s made by orang-utans when they are disturbed by predators like humans, tigers or snakes, or even by rivals of their own species. You can do it yourself: purse your lips together and suck air in sharply to produce a squeaky kissing sound. All orang-utans do it and because these apes are largely solitary, the calls are unlikely to be alarms – they’re probably deterrents instead.
Hardus spent over two years recording over 1,000 kiss-squeaks from 23 wild orang-utans and found that the pitch of the squeaks reflect the size of the animal. Calls made by adult females have a higher maximum frequency than the large elder males, while those made by immature youngsters are the highest of all. This means that the calls could potentially provide information to a canny listener about the size and power of the caller.
To some extent, orang-utans can fake a deeper call by placing a hand in front of their lips, but leaves are the greatest equaliser of all. By stripping a bundle of leaves from a twig and holding them in front of their mouths, even a small adolescent can drop the pitch of its call to below the level of a large unaided male.