The Lourdes miracles were one of the first things that got me interested in the placebo effect and they got me thinking about the potential power that the placebo effect could have under the right conditions.
The cultural differences in the placebo effect. How taste, trust and cultural sensitivity can affect global health.
As patients, we are often faced with the choice between branded drugs or their generic counterparts. Some people do experience better effects from branded treatments, but what's really going on in branded vs generic drugs.
Irritable bowel syndrome (IBS) affects 10-15% of people around the world. It is a chronic gastrointestinal disorder with symptoms including abdominal pain, discomfort, diarrhoea and constipation. Most medications are used to treat these symptoms independently of each other and few treatments relieve the symptoms of IBS as a whole (Drossman et al. 2010). Studies have demonstrated that there is a substantial, clinically significant placebo effect for IBS. This then led Harvard researchers to investigate if using placebo for IBS could be both ethical and effective.
Studies have shown the efficacy of placebos in clinical practice, but the ethical issues are less well defined. To answer the question: is the placebo effect ethical, we evaluate the placebo effect alongside the four ethical principles of medicine
Placebos are widely used in medical practice, although the exact numbers are not known. Surveys have shown that somewhere between 57-97% of doctors admit to using placebos in their clinical practice. Placebos would not be used so prevalently if they did not have positive effects, but it's vitally important that placebos are used as ethically as possible to avoid harming the doctor-patient relationship. Here, we outline different types of placebo usage, the ethical considerations and the current medical guidelines for placebos in clinical practice.
There is something very empowering about the placebo effect and the idea that we can heal ourselves. For decades, we've known about the placebo effect, but we've been unable to use it ethically in healthcare. One of the primary obstacles to using placebos in healthcare, was informed consent. It was thought that placebos necessarily required deception - the patient had to believe it would work. However, renowned placebo researcher - Ted Kaptchuk - realised that no one had ever put that theory to the test. So he began a research programme into identifying if people could respond to placebos even if they knew they were taking placebos. The results have changed how we think about placebos in healthcare.
Did you know that placebo effects and nocebo effect can be evoked without a placebo; or how about the unspoken ethics code when it comes to prescribing placebos? In a talk by Dr Luana Colloca we learn about the conflicts, ethics and future use of the placebo effect in clinical practice. Here, we summarise some of the key ideas in Dr Colloca's talk.
In 1983, a groundbreaking study was published demonstrating that architectural environment influences recovery from surgery. Benedetti described the placebo as "the whole ritual of the therapeutic act", so why shouldn't that also include the clinical environment? In this article, we explore the 1983 study and the implications of this in global health.
Alain de Botton's "The Architecture of Happiness" was one of the books that first got me thinking about how buildings can physically affect us. At Yekize, we believe that the placebo effect, is not just about what you take, but also about other factors such as the doctor-patient relationship and the clinical setting - so why not take architecture into consideration as well?