Placebo

Placebo Effects in Medicine

Ted J. Kaptchuk, and Franklin G. Miller, Ph.D.

N Engl J Med 2015; 373:8-9July 2, 2015DOI: 10.1056/NEJMp1504023

 Comments open through July 8, 2015

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Interview with Prof. Ted Kaptchuk on the outlook for harnessing the benefits of placebo effects in medicine. (12:51)

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Placebo effects are often considered the effects of an “inert substance,” but that characterization is misleading. In a broad sense, placebo effects are improvements in patients' symptoms that are attributable to their participation in the therapeutic encounter, with its rituals, symbols, and interactions. These effects are distinct from those of discrete therapies and are precipitated by the contextual or environmental cues that surround medical interventions, both those that are fake and lacking in inherent therapeutic power and those with demonstrated efficacy. This diverse collection of signs and behaviors includes identifiable health care paraphernalia and settings, emotional and cognitive engagement with clinicians, empathic and intimate witnessing, and the laying on of hands./.../