May the placebo be the best possible therapy in principle? Is being a doctor not just a science, but an art of relating?
Keywords:
placebo, nocebo, therapies, self-healing powers, healthcare
Abstract
Placebo drugs are mainly used in clinical studies as a comparison group to the so-called verum. One might therefore think that placebos have no effect at all. However, this is a misconception, as there are a large number of international studies that have been able to demonstrate positive placebo effects. On average, around 35% of patients respond positively. Placebos do not force the organism to do anything, they work together with its self-healing powers. With no side effects and very inexpensive, they could take their rightful place in the healthcare system in the future.
References
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Park, L. C., & Covi, L. (1965). Nonblind placebo trial: an exploration of neurotic patients' responses to placebo when its inert content is disclosed. Archives of General Psychiatry, 12(4), 336-345. https://doi.org/10.1001/archpsyc.1965.01720340008002
Scientific Advisory Board of the German Medical Association (2010). Statement "Placebo in der Medizin". Dtsch Arztebl, 107(28-29), A-1417 / B-1253 / C-1233.
Sham surgery (2008). Sham surgery: the placebo effect also deceives surgeons. Ärzte Zeitung. October 27, 2008.
Stolberg, M. (1996). Homeopathy on the touchstone. The first double-blind trial in the history of medicine in 1835. Münchner Medizinische Wochenschrift, 138, 364-366.
Ter Riet, G., de Craen, A. J., de Boer, A., & Kessels, A. G. (1998). Is placebo analgesia mediated by endogenous opioids? A systematic review. Pain, 76(3), 273-275.
von Uexküll, T. & Langewitz, W. (2008). The placebo phenomenon. In: Psychosomatic medicine: Models of medical thought and action (pp. 311). Urban & Fischer/Elsevier.
Wiesing, U. & Parsa-Parsi, R. (2015). The new Declaration of Helsinki. In D. Sturma, B. Heinrichs, & L. Honnefelder (Eds.), Jahrbuch Medizin, Ethik und Recht (Vol. 19, No. 1, pp. 253-276). Walter de Gruyter, Berlin / Boston.
Amanzio, M., & Benedetti, F. (1999). Neuropharmacological dissection of placebo analgesia: expectation-activated opioid systems versus conditioning-activated specific subsystems. Journal of Neuroscience, 19(1), 484-494.
Beecher, H. K. (1955). The powerful placebo. Journal of the American Medical Association, 159(17), 1602-1606.
Bernateck, M., Karst, M., Eberhard, S., Vivell, W., Fischer, M. J., & Stichtenoth, D. O. (2009). Placebotherapie. Der Schmerz, 23(1), 47-53. https://doi.org/10.1007/s00482-008-0733-x
Binsack, C., Liebsch, H., Raabe, K., & Sachs, C. (2012). The placebo effect - faith as medicine? (Memento of January 19, 2012 in Internet Archive). Quarks & Co (p.14).
Bschor, T., Nagel, L., Unger, J., Schwarzer, G., & Baethge, C. (2024). Differential Outcomes of Placebo Treatment Across 9 Psychiatric Disorders: A Systematic Review and Meta-Analysis. JAMA Psychiatry, 81(8), 757–768. https://doi.org/10.1001/jamapsychiatry.2024.0994
Charlesworth, J. E., Petkovic, G., Kelley, J. M., Hunter, M., Onakpoya, I., Roberts, N., ... & Howick, J. (2017). Effects of placebos without deception compared with no treatment: a systematic review and meta‐analysis. Journal of Evidence‐Based Medicine, 10(2), 97-107. https://doi.org/10.1111/jebm.12251
Dean, M. E. (2006). ‘An innocent deception’: placebo controls in the St Petersburg homeopathy trial, 1829–1830. Journal of the Royal Society of Medicine, 99(7), 375-376. https://doi.org/10.1258/jrsm.99.7.375
Ernst, E., & Resch, K. L. (1995). Concept of true and perceived placebo effects. BMJ, 311(7004), 551-553. https://doi.org/10.1136/bmj.311.7004.551
German Medical Association on the recommendation of its Scientific Advisory Board (Eds.) (2011). Placebo in der Medizin. Deutscher Ärzte-Verlag, Cologne.
German Pain Congress (2007). How well pain therapy works also depends on expectations. General practitioner highlights from the German Pain Congress. MMW - Progress in Medicine, 149(51-52), 6.
Hróbjartsson, A., & Norup, M. (2003). The use of placebo interventions in medical practice—a national questionnaire survey of Danish clinicians. Evaluation & The Health Professions, 26(2), 153-165. https://doi.org/10.1177/0163278703026002002
Jütte, R. (2010). The History of Placebo. World Medical Journal, 56, 109-114.
Jütte, R. (2014). Hahnemann and Placebo. Homeopathy, 103, 208-212.
Jütte, R. (2019). Early examples of the healing power of imagination: The prehistory of the placebo. MedGG, 37, 135-154.
Kaptchuk, T. J., Kelley, J. M., Conboy, L. A., Davis, R. B., Kerr, C. E., Jacobson, E. E., ... & Lembo, A. J. (2008). Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome. BMJ, 336(7651), 999-1003. https://doi.org/10.1136/bmj.39524.439618.25
Kienle, G. S., & Kiene, H. (1997). The powerful placebo effect: fact or fiction?. Journal of Clinical Epidemiology, 50(12), 1311-1318. https://doi.org/10.1016/S0895-4356(97)00203-5
Levine, J. D. et al. (1978). The mechanisms of placebo analgesia. Lancet, 2, 654-657.
Lichtenberg, P. (2008). The role of the placebo in clinical practice. McGill Journal of Medicine: MJM, 11(2), 215-216.
Meissner, K., Bingel, U., Colloca, L., Wager, T. D., Watson, A., & Flaten, M. A. (2011). The placebo effect: advances from different methodological approaches. Journal of Neuroscience, 31(45), 16117-16124. https://doi.org/10.1523/JNEUROSCI.4099-11.2011
Merrill, R. M. (2009). Introduction to Epidemiology. Jones and Bartlett.
Meyer, R. (2008). Declaration of Helsinki: Better protection of patients in clinical trials. German Medical Journal, 105(45), A-2362 / B-2016 / C-1964.
Moseley, J. B., O'malley, K., Petersen, N. J., Menke, T. J., Brody, B. A., Kuykendall, D. H., ... & Wray, N. P. (2002). A controlled trial of arthroscopic surgery for osteoarthritis of the knee. New England Journal of Medicine, 347(2), 81-88. https://doi.org/10.1056/NEJMoa013259
Oken, B. S. (2008). Placebo effects: clinical aspects and neurobiology. Brain, 131(11), 2812-2823. https://doi.org/10.1093/brain/awn116
Park, L. C., & Covi, L. (1965). Nonblind placebo trial: an exploration of neurotic patients' responses to placebo when its inert content is disclosed. Archives of General Psychiatry, 12(4), 336-345. https://doi.org/10.1001/archpsyc.1965.01720340008002
Scientific Advisory Board of the German Medical Association (2010). Statement "Placebo in der Medizin". Dtsch Arztebl, 107(28-29), A-1417 / B-1253 / C-1233.
Sham surgery (2008). Sham surgery: the placebo effect also deceives surgeons. Ärzte Zeitung. October 27, 2008.
Stolberg, M. (1996). Homeopathy on the touchstone. The first double-blind trial in the history of medicine in 1835. Münchner Medizinische Wochenschrift, 138, 364-366.
Ter Riet, G., de Craen, A. J., de Boer, A., & Kessels, A. G. (1998). Is placebo analgesia mediated by endogenous opioids? A systematic review. Pain, 76(3), 273-275.
von Uexküll, T. & Langewitz, W. (2008). The placebo phenomenon. In: Psychosomatic medicine: Models of medical thought and action (pp. 311). Urban & Fischer/Elsevier.
Wiesing, U. & Parsa-Parsi, R. (2015). The new Declaration of Helsinki. In D. Sturma, B. Heinrichs, & L. Honnefelder (Eds.), Jahrbuch Medizin, Ethik und Recht (Vol. 19, No. 1, pp. 253-276). Walter de Gruyter, Berlin / Boston.
Published
2024-11-13
How to Cite
Doepp, M. (2024). May the placebo be the best possible therapy in principle? Is being a doctor not just a science, but an art of relating?. European Journal of Science, Innovation and Technology, 4(5), 176-183. Retrieved from https://ejsit-journal.com/index.php/ejsit/article/view/547
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