Robin Nunn has argued that we should stop using the terms ‘placebo’ and ‘placebo effect’. I argue in support of Nunn’s position by considering the logic of why we perform placebo comparisons. Like all comparisons, placebo comparison is just a case of comparing one thing with another, but it is a mistake, I argue, to think of placebo comparison as a case where something is compared to ‘a placebo’. Rather, placebo comparison should be understood as a situation which sets-up the (...) treatment and control groups in a particular way; not as a case involving objects or procedures called ‘placebos’ employed in order to control for ‘placebo effects’. (shrink)

Despite strong growth in scientific investigation of the placebo effect, understanding of this phenomenon remains deeply confused. We investigate critically seven common conceptual distinctions that impede clear understanding of the placebo effect: (1) verum/placebo, (2) active/inactive, (3) signal/noise, (4) specific/nonspecific, (5) objective/subjective, (6) disease/illness, and (7) intervention/context. We argue that some of these should be eliminated entirely, whereas others must be used with caution to avoid bias. Clearing away the conceptual underbrush is needed to lay down a path to understanding (...) and harnessing placebo effects in clinical medicine. (shrink)

The placebo effect, in recent years, has been the focus of extensive scientific inquiry and public fascination, as reflected in articles in the news media. Authors writing about placebo effects often mention the goal of harnessing the placebo effect for the benefit of patients in clinical practice. This suggests that the placebo effect is like a powerful horse, which needs to be put in harness in order to do useful work. However, developing an accurate understanding of what has been labelled, (...) often misleadingly, as the "placebo effect" and taking advantage of this phenomenon have been hampered by the conceptual muddle surrounding this topic. To continue the equine metaphor... (shrink)

Frank Ebersole's extraordinary investigations of certain key philosophical ideas behind problems in epistemology and metaphysics are the subject of this article-review. I have resisted providing what many readers will expect me to provide, namely, a critical examination of his philosophical methodology. I do question his unwilligness to say why his investigations only yield I negative results, and I do have something to say about classifying him as an ordinary language philosopher. However, my main focus is on trying to engage critically (...) with what he actually does in his work. To this end, I provide a narrative of the investigation he carries out into the possibility of comparing the objects of perception and dreams, and I cite other works of his in support of my understanding of that investigation. Although one of his lengthiest essays seems to be devoted to an anticipation of an objection to his approach, I explain why even there he is not concerned with the question of why he always seems to get negative results. After suggesting why some of his later essays seem to be so hard to read, I conclude by saying something about what I take to be his achievement. (shrink)

Is there a response, which is not accounted for by regression to the mean, natural history, the Hawthorne effect?The term placebo comes to us from the Latin for "I shall please," indicating that the phenomenon known as the "placebo effect" or "placebo response" has been familiar to medical practitioners for a number of centuries, at least. As we reached the mid-20th century and randomized controlled trials became a central feature of medical research, the use of controls and blinding in those (...) trials allowed for the isolation of the placebo effect in ways that made it much clearer that there... (shrink)

Debates about the ethics and effects of placebos and whether ‘placebos’ in clinical trials of complex treatments such as acupuncture are adequate rage. Yet there is currently no widely accepted definition of the ‘placebo’. A definition of the placebo is likely to inform these controversies. Grünbaum’s characterization of placebos and placebo effects has been touted by some authors as the best attempt thus far, but has not won widespread acceptance largely because Grünbaum failed to specify what he means by a (...) therapeutic theory and because he does not stipulate a special role for expectation effects. Grünbaum claims that placebos are treatments whose ‘characteristic features’ do not have therapeutic effects on the target disorder. I show that with four modifications, Grünbaum’s definition provides a defensible account of placebos for the purpose of constructing placebo controls within clinical trials. The modifications I introduce are: adding a special role for expectations, insisting that placebo controls control for all and only the effects of the incidental treatment features, relativizing the definition of placebos to patients, and introducing harmful interventions and nocebos to the definitional scheme. I also provide guidance for classifying treatment features as characteristic or incidental. (shrink)

A resilient issue in research ethics is whether and when a placebo-controlled trial is justified if it deprives research subjects of a recognized treatment. The clinicians' moral duty to provide the best available care seems to require the use of ‘active’ controlled trials that use an established treatment as a control whenever such a therapy is available. In another regard, ACTs are supposedly methodologically inferior to PCTs. Hence, the moral duty of the clinical researcher to use the best methods will (...) favor PCTs. In this target article, I analyze the three reasons for believing that ACTs are inferior to PCTs namely: 1) ACTs lack ‘assay sensitivity’; 2) ACTs do not measure absolute effect size; and 3) ACTs require more participants; and I contend that none are acceptable. Consequently the tension between clinical and research ethics dissolves: the moral duty of the clinician to avoid PCTs is unopposed by methodological considerations. (shrink)

Interessanter Artikel. Ebersole fordert ein extensionales Kriterium für die Unterscheidung, erklärt die Suche aber für aussichtslos. Er betont, dass nur Aussagen analytisch sind, nicht Sätze. Er betont, dass empirische Allsätze weder prinzipiell analytisch noch synthetisch sind, ihr Wahrheitswert ist unbestimmt. Erst, wenn wir alle Gegenstände kennen, die unter den allquantifizierten Begriff fallen, können wir dies sagen. (Hier habe ich Probleme, da ich Allquantifikation über undefinierten Begriffen unzulässig finde.).