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Placebo effect

Overview

The placebo effect is the improvement in a patient's reported condition that follows a treatment with no active ingredient, produced by the patient's expectation of improvement, the ritual of being treated, and the attention of the person treating them. The word is Latin for "I shall please".

Notes

  • The effect is real but is mostly an effect on reported symptoms: pain, nausea, fatigue, mood. Placebos do not shrink tumours, cure infections, or mend bones. The clearest demonstration is that placebo effects are large for conditions measured by asking the patient and close to zero for conditions measured by instruments.
  • Much of what is attributed to placebo is in fact regression to the mean and the natural course of self-limiting illness. A properly designed trial has a no-treatment arm as well as a placebo arm for this reason.
  • The placebo effect is the entire mechanism of Homeopathy, and the honest conclusion is not that homeopathy "works through placebo" but that the sugar pill is doing nothing and the consultation is doing a little. The consultation does not require the sugar pill, nor the pretence that it is medicine.
  • The nocebo effect is the mirror image: expectation of harm produces reported harm. It accounts for a good deal of the reported symptoms of "electromagnetic sensitivity" (5G Towers) and of mild vaccine side effects reported in placebo arms of trials (Anti-Vaccine).

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