SO what is a placebo? Generally, it is an ineffective treatment which actually alleviates symptoms. They are widely used in medicine and medical research and its effect is a phenomenon!
It shouldn’t work… but it does!!
We are conditioned to believe that medicine makes us better when we’re ill, because of our increased faith in the power of modern medicine. Our confidence in drugs being effective has grown, so any treatment that we receive makes us psychologically confirm this belief. This belief causes placebos to work. Take for example, Khan* who found that in 96 clinical trials, sugar pills were often as effective as antidepressants.
Those that think that a treatment will work, display a stronger placebo effect, than those who do not. This is because it is based on the perceptions and expectations that people have. Placebos can help smokers quit, reduce the effects of allergies, because we believe it does. It was found that when a placebo is prescribed as a stimulant, it has an effect on heart rhythm and blood pressure, but when prescribed as a depressant, it has the opposite effect, (Kirsch, 1997)* all because placebos are dependant upon perception and expectation.
Because of these perceptions and expectations, various factors can change how strong the placebo effect is. These factors include, the colour and size of the pills. Several studies have found that red and yellow pills worked better as a stimulant, whilst blue and purple pills worked better as depressants, (Craen et al, 1996)*.
Beecher (1955)* found that 35% of patients were satisfactorily relieved by a placebo alone, although it is worth noting that research into this, varies greatly and is often much higher, (Turner et al, 1994)*. However a more recent study by Hróbjartsson and Götzsche (2001)* found little evidence that placebos had clinical effects, suggesting that the placebo effect works selectively.
So while placebos may seem great, clearly a placebo does have its disadvantages.
Its use raises many ethical issues. For example, it creates false pretences, building up hopes of those who take it, offering it as a substitute or an alternative, when in reality, it is no such thing. Their effect is unreliable and unpredictable, and shouldn’t form the basis of any treatment. Another example is giving it, to act as a control. It is unfair not to give a group a treatment, which could actually work. Along side this, is the old debate of deception. Is it fair to maintain that deception, especially when the treatment is bogus? Well not really, no. We should not deceive people and have an obligation to relieve the pain and suffering.
Other disadvantages include unwanted side effects, such as drowsiness, nausea and rashes. The placebo can also hide symptoms of a possible serious illness. Withdrawal symptoms can also occur. 41% of women who has been on a placebo for 6years suffered moderate or severe withdrawal symptoms, (Women’s Health Initiative)*.
To conclude, the placebo effect is a real and powerful psychological response. It is generally a beneficial response, although due to the nature of its feel-good factor it is possible that symptoms of a serious illness could be masked by it. The placebo effect has been controversial in history, but has played a huge role in medical research and pharmacology, suggesting it does work. But does it truly work?! You decide….