Placebo Effects in the Meta-Analyses of Hrobjartsson and Gotzsche - Essay Example

For this paper, a literature search was undertaken using the Internet to source studies meeting the criteria set by Hrobjartsson and Gotzsche, this being that a clinical study has a placebo and no treatment control design, with random assignment of patients. It is anticipated that the present dissertation will provide evidence for the existence of placebo effects. As well, this paper will contribute positively to the extension of understanding placebo effects in general, as well as identifying factors necessary in research design to allow for a placebo effect to occur if one does exist. Overall, it is contended in this paper that placebo effects, and their study, can positively benefit patients’ well-being and the scientific research process itself.


CHAPTER ONE: Introduction – Defining the Placebo

“Placebo Domino in regione vivorum”
-Latin psalm 116, verse 9, cited in Walach (2003)
I shall please the Lord in the land of the living.

In ancient times the medicine was proscribed in the form of ritual. For example, the Byzantine scribe Alexander of Trallers wrote that gout was to be treated with a mixture of myrrh and piglet cecum, wrapped in dogskin and worn as an amulet around the neck (Shapiro & Shapiro, 1997). In Pergamon (Turkey), at the sanctuary of Asclepius, patrons took part in rituals of fasting, sacrifices, sleeping within the temple, bathing in sea salts, and fumigation in combination with herbal infusions and anointing with oils, as a therapy to combat physical and mental illnesses (Shapiro & Shapiro, 1997). The philosopher Maimonides, in the 11th century, advised impotent men to urinate into the hollow of a carrot to find relief (Shapiro & Shapiro, 1997). At these times, there was no differentiation between medicine and substances that produced sham effects, all medicine was placebo (Shapiro & Shapiro, 1997). During the 12th century, the word placebo came into use during the singing of Vespers for the dead, wherein professional mourners were hired “to sing a placebo.” Later, the word became secular shorthand in reference to a servile person, a sycophant (Shapiro & Shapiro, 1997).
It was not until the early 19th century that the word placebo took on a medical reference (Shapiro & Shapiro, 1997). Hooper's 1812 Medical Dictionary defined placebo as a label for any type of medicine that was prescribed to please the patient, more than benefit them (Shapiro & Shapiro, 1997). However, it is unclear exactly when during the next century that the term placebo took on its clinical definition as used in contemporary medicine and research, namely, as a substance that has no medical effect (Shapiro & Shapiro, 1997).
The first known double-blind study that incorporated a placebo group was undertaken by Rivers (1907, cited in Hart, 1999). He investigated the relationship between fatigue and an assortment of drugs, including alcohol.