Talk:Placebo

message: I have attempted to edit this line, but was reverted: "The use of placebos as treatment in clinical medicine raises ethical concerns, as it introduces dishonesty into the doctor–patient relationship." However, for example, if the patient were *told* that they were being given a placebo, then there would be no dishonesty.  It is possible that this statement is being taken out of context from the cited work.  As it stands, the statement is misleading.  Perhaps more context from the cited work can be given to illustrate the way in which giving a placebo might introduce dishonesty into a doctor-patient relationship. Gitpushoriginmaster (talk) 15:24, 26 November 2019 (UTC)
replies: text: The reason is clear - bypassing informed consent. The scenario you set out does not appear in the sources we cite, does it? Alexbrn (talk) 15:34, 26 November 2019 (UTC)
replies: text: I concur with Alexbrn, "bypassing informed consent" was recently added in fact to precisely clarify why placebo may introduce dishonesty. But I think I see what you mean: I need to check but I think that there are studies showing that the placebo effect can still happen even when the patient is informed, in which case there would be no bypassing of informed consent. I need to check for sources then, but this may make this statement about dishonesty a bit too strong, but then this can be easily fixed by changing "as it introduces dishonesty" -> "as it may introduce dishonesty". Let me check for sources and we'll see. --Signimu (talk) 21:14, 26 November 2019 (UTC)
replies: text: Found that it's called "open-label placebos", but need to find a review and if multiple studies reproduced the result. Also, the lede only mentions the informed consent issue, but it should probably also mention the fact that in clinical research patients are given a placebo when there are effective medications available (as described later in the article), this is also an ethical issue. --Signimu (talk) 00:09, 27 November 2019 (UTC)

text: Found 3 reviews on open-label placebos:  and 1 in french (but not focused on open-label placebos). --Signimu (talk) 00:27, 27 November 2019 (UTC)
replies: text: What happens in research is another matter, the text in question applies to what happens in clinical medicine. Alexbrn (talk) 08:07, 27 November 2019 (UTC)

text: @Signimu, "as it may introduce dishonesty" is exactly the change I attempted to make.  I'm glad you concur. Gitpushoriginmaster (talk) 19:11, 17 December 2019 (UTC)

text: I have edited the lede to clarify that placebos do not need to be disguised in order to be considered placebos or to have placebo effects. It also includes a note about the ethical issues of using a placebo as a control in a clinical trial when there is already an existing treatment. Anywikiuser (talk) 12:07, 27 November 2019 (UTC)
thread_title:  Needs clarification 

message: I have seen objections to the term "placebo effect" for a couple of reasons. Some are technical, basically that it is a fuzzy term that can cover a mixture of several effects that should be considered separately: reporting bias in RCT + social ritual healing (common knowledge is that going to the doctor and following her instructions make people better, and that expectation makes it happen) + various noise in remission statistics (reversal to the mean, spontaneous remission etc.); here is a possible source discussing it. Some are political: the name "placebo effect" allows cranks to say "well, there is an effect" and convince the public in a way "as efficient as sugar" does not (see the start of that though I doubt that is a reliable source by WP's standards).
I would think my first source is enough to justify a redirect from contextual effect to here and a small mention in the lead but I have no idea how well-received in the community those views are (if they are totally fringe, we probably should not). Non-expert me has found Google Scholar hits for "placebo effect" (163k) vs "contextual effect" (15k, most seem to be about medicine) that indicate the term is in use, but that is hardly convincing ("faith healing" scores 24k).
The political objections might be worth a discussion too somewhere but only if it is a sourceable view (not necessarily among practitioners, but also among skeptics, governmental bodies, etc.). For obvious reasons I found mostly opinion pieces to that effect. TigraanClick here to contact me 14:26, 11 February 2020 (UTC)
thread_title:  Creating a redirect from [[contextual effect]]? 

message: Reading the article feels like a true rollercoaster, which is pretty troublesome when you want to get a sense of the validity of the concept.
What i mean is that the article contains several quotes and sources about deeming placebo insignificant, dubious or outright dismissible, while at the exact same time it provides factual data that its a very much existing, functioning and measurable concept, especially with pain, nausea, depression.
In its nature the article is completely self-defeating, because if its taken at face value, one is left with a PhD level demonstration of what gossip among scientists and medical professionals looks like with everyone throwing slanted/partial data in the pool, then at the end you are exactly where you started: It exists, maybe, but we cant really figure how much, but its most certainly insignificant, except when its not.
I mean... is this supposed to be some red tape bureaucratic comedy? Whilst writing these articles, you might wish to provide a factual, on ground conclusion. An answer if you will instead of tossing in pro and contra data points left and right, creating an informational mire.
37.191.17.124 (talk) 00:21, 1 November 2021 (UTC)
replies: text: Yeah, this article does seem weird.  It seems to be stating repeatedly that The Powerful Placebo was debunked and implying that there's no such thing as the placebo effect, which seems unlikely given the extent of the measures that usually seem to be taken to allow for the placebo effect in clinical trials.  Possibly it just means that the particular data used in The Powerful Placebo were duds, rather than that the placebo effect doesn't exist?  If so, it might make sense for it to say so.  Wombat140 (talk) 04:16, 16 December 2022 (UTC)

text: I think the issue here is that while the idea of a Placebo Effect for quantitative health outcomes has been debunked, patients still *self-report* things like decreased pain, reduced depression, etc. I agree the article would benefit with being restructured to first cover the "history and debunking" of a "real placebo effect" (historical misunderstanding of regression to the mean) and then continue with a discussion of the "actual placebo effect" as it related to self-reported conditions. Meekohi (talk) 13:46, 23 August 2023 (UTC)
thread_title:  Self contradiction