Pills, liquid, or powder with no treatment value can be harmful to the doctor-patient relationship, which is predicated on a mutual trust, some say
You might wonder, lately, if placebos can confer genuine health benefits to some people with illness. If you're reviewing a serious publication like the New England Journal of Medicine, you could be persuaded by results of a recent article on giving placebos to asthma patients in a randomized clinical trial. The topic has blossomed since 2008, when PLoS One reported on the use of mock treatments, without concealment, in people with irritable bowel syndrome. In that small study, participants experienced symptomatic relief even though they knew they were getting bogus remedies. Now, upon perusing the New Yorker, you might be mesmerized by Michael Specter's intriguing story on the history of placebos and burgeoning, research-minded attention to this highly-debatable subject at the intersection of health care, science, and medical ethics.
One area of consensus is the centricity of semantics in the discussion. How doctors define a placebo varies. In this light, any outcomes -- good, bad, or negligible -- ascribed to a placebo effect would depend on the term's meaning. According to the NIH-sponsored Clinical Trials website, a "placebo is an inactive pill, liquid, or powder that has no treatment value." But investigators in the field -- and skeptics too -- wonder about a gray zone where doctors prescribe low-dose or seemingly innocuous treatments but don't call these placebos. Perhaps the mystery lies in science -- how these can affect the mind's expectation of relief and, sometimes, harness hidden-but-powerful aspects of the doctor-patient relationship.