Skip to main content
Log in

The concept of placebo

  • Published:
Science and Engineering Ethics Aims and scope Submit manuscript

Abstract

This paper attempts to define the concept of placebo as it is used in the clinical context The author claims that X is a placebo if and only if X has such a property dp, that whenever in a therapeutic situation T a stimulus S appears, then in attending conditions A, it will cause a beneficial reaction R in the patient. Formally, the same structure may be used to define any pharmacologically active drug. The main difference between the drug and a placebo is in the range of possible substitutions for X and the property d. For the active drug there is only one possible substitution for X and property d and it can be scientifically explained why, and how the drug works. In the case of a placebo a set of possible substitutions for X and d is open, and so far it is impossible to offer any scientifically valid explanation of the action mechanism of placebo.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Beecher, H.K. (1955) The powerful placebo, JAMA, 159: 1602–1606. Beecher, H.K. (1961) Surgery as placebo: a quantitative study of bias. JAMA 176: 1102–7.

    Google Scholar 

  2. Cf. Roberts, A.H., Kewman, D.G., Mercier L. and Hovell, M. (1993) The Power of nonspecific effects in healing: implications for psychosocial and biological treatments. Clinical Psychology Review 13: 375–391.

    Article  Google Scholar 

  3. Claridge, G. (1970) Drugs and Human Behaviour, Allen Lane, London.

    Google Scholar 

  4. Helman, C.G. (1996) Culture, Health and Illness, 3rd edition, Butterworth, Heinemann, Oxford.

    Google Scholar 

  5. Ibid.Helman, C.G. (1996) Culture, Health and Illness, 3rd edition, Butterworth, Heinemann, Oxford 196.

    Google Scholar 

  6. Harrington, A. (2002) “Seeing” the placebo effect: historical legacies and present opportunities, in: Guess H. A., Kleinman, A., Kusek, J. W, Engel, L. W., eds. The Science of Placebo: Toward an Interdisciplinary Research Agenda, BMJ Books, London.

    Google Scholar 

  7. Wulff, H.R., Pedersen, S.A. and Rosenberg, R. (1986) Philosophy of Medicine. An Introduction. Blackwell Scientific Publications, Oxford, London, Edinburgh, p. 64. Cf. Wulff, H.R., Gøtzsche P.C. (2000) Rational Diagnosis and Treatment. Evidence-Based Clinical Decision Making. 3rd ed. Blackwell Science, Oxford, London, Edinburgh, p. 107–111.

    Google Scholar 

  8. Helman, C.G. (1981) ‘Tonic’, ‘fuel’, and ‘food’: social and symbolic aspects of the long-term use of psychotropic drugs. Social Science and Medicine, 15B: 521–33.

    Google Scholar 

  9. Amanzio, M. and Benedetti, F. (1999) Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems, Journal of Neuroscience 119(1): 484–94.

    Google Scholar 

  10. Siegel, S. (1997) Explanatory Mechanisms for placebo effects — Pavlovian conditioning, in: Harrington, A. ed. The Placebo Effect: An Interdisciplinary Exploration. Harvard University Press. Cambridge, Mass.

    Google Scholar 

  11. Brody, H.(1980) Placebos and the Philosophy of Medicine: clinical, conceptual, and ethical issues, University of Chicago Press, Chicago, Ill. Cf. Brody, H. (2000) The Placebo Response. Recent Research and Implications for Family Medicine. The Journal of Family Practice 49: 649–654.

    Google Scholar 

  12. Lown, B. (1999) The Lost Art of Healing, Ballantine Books, New York.

    Google Scholar 

  13. Grünbaum, A. (1986) The placebo concept in medicine and psychiatry. Psychological Medicine, 16: 19–38.

    Article  Google Scholar 

  14. Stevenson, Ch.L. (1963) Facts and Values. Studies in Ethical Analysis, Yale University Press, New Haven and London, p. 32.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Zbigniew Szawarski.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Szawarski, Z. The concept of placebo. SCI ENG ETHICS 10, 57–64 (2004). https://doi.org/10.1007/s11948-004-0063-z

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11948-004-0063-z

Keywords

Navigation