Friday 9 March 2007

The Placebo Effect

As you might expect, for the book Darian and I were very interested in what is termed the 'Placebo effect'. Fascinating changes to bodily symptoms can be produced by 'inert' medication or 'fake' surgery in ways which depend upon its presentation, for example, a pill's colour, but perhaps most importantly upon a physician's belief in the treatment's efficacy.

An excellent book on this topic is medical anthropologist Daniel E. Moerman's Meaning, Medicine and the 'Placebo Effect', Cambridge University Press, 2002. Online you can gain a good idea of the range of this book from an informative review in the London Review of Books, and from an article Moerman co-authored with Wayne B. Jonas, 'Deconstructing the Placebo Effect and Finding the Meaning Response':
Abstract: We provide a new perspective with which to understand what for a half century has been known as the “placebo effect.” We argue that, as currently used, the concept includes much that has nothing to do with placebos, confusing the most interesting and important aspects of the phenomenon. We propose a new way to
understand those aspects of medical care, plus a broad range of additional human experiences, by focusing on the idea of “meaning,” to which people, when they are sick, often respond. We review several of the many areas in medicine in which meaning affects illness or healing and introduce the idea of the “meaning response.” We suggest that use of this formulation, rather than the fixation on inert placebos, will probably lead to far greater insight into how treatment works and perhaps to real improvements in human well-being. Annals of Internal Medicine 2002;136:471-476.
You can read there about differences in placebo effects across countries, e.g., Germans are more responsive to ulcer placebos than fellow Europeans, but less so with blood-pressure drugs. Also Chinese Americans dying from lymphatic cancer who were born in an 'Earth year', according to their calendar, died on average nearly 4 years earlier than those dying from the same condition but born in other years.

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