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Understanding and harnessing placebo effects: clearing away the underbrush
Franklin G Miller1, Howard Brody
1Department of Bioethics, Clinical Center, National Institutes of Health, Building 10, Room 1C118, Bethesda, MD 20892, USA. fmiller@nih.gov
The Journal of Medicine and Philosophy
|January 12, 2011
Summary
Scientific understanding of the placebo effect is confused. This study critically examines seven common distinctions, arguing some should be eliminated and others used cautiously to improve clinical applications.
Area of Science:
- Medical Research
- Psychology
- Clinical Medicine
Background:
- The placebo effect is increasingly studied, yet conceptual clarity remains elusive.
- Existing frameworks for understanding placebo effects are often ambiguous and hinder progress.
Purpose of the Study:
- To critically analyze seven common conceptual distinctions that obscure the understanding of the placebo effect.
- To propose a clearer conceptual framework for studying and applying placebo effects in clinical settings.
Main Methods:
- Critical review and conceptual analysis of seven established distinctions related to the placebo effect.
- Examination of how these distinctions impact research and clinical practice.
Main Results:
- Identified seven key conceptual distinctions (verum/placebo, active/inactive, signal/noise, specific/nonspecific, objective/subjective, disease/illness, intervention/context) that impede understanding.
- Argued for the elimination of some distinctions and cautious use of others to mitigate bias.
Conclusions:
- Clearing conceptual underbrush is essential for advancing the scientific understanding of the placebo effect.
- Refined conceptual distinctions will facilitate better harnessing of placebo effects in clinical medicine.
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