Theoretical Medicine and Bioethics

, Volume 32, Issue 4, pp 229–243 | Cite as

The placebo phenomenon and medical ethics: Rethinking the relationship between informed consent and risk–benefit assessment

  • Franklin G. Miller
  • Luana Colloca


It has been presumed within bioethics that the benefits and risks of treatments can be assessed independently of information disclosure to patients as part of the informed consent process. Research on placebo and nocebo effects indicates that this is not true for symptomatic treatments. The benefits and risks that patients experience from symptomatic treatments can be shaped powerfully by information about these treatments provided by clinicians. In this paper we discuss the implications of placebo and nocebo research for risk–benefit assessment and informed consent.


Placebo response Nocebo effect Informed consent Risk–benefit assessment 



We thank Annette Rid, Reidar Lie, and Alan Wertheimer for helpful comments on previous drafts of this paper. This research was supported by the Intramural Research Program of the Clinical Center, NIH and the National Center for Complementary and Alternative Medicine.


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Copyright information

© Springer Science+Business Media B.V. (outside the USA) 2011

Authors and Affiliations

  1. 1.Department of Bioethics Clinical CenterNational Institutes of HealthBethesdaUSA
  2. 2.National Center for Complementary and Alternative MedicineNational Institutes of HealthBethesdaUSA

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