near-death experiences, and much more!

The Mysterious Placebo

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   One of the most significant but widely misunderstood phenomena is the
   placebo effect. Research shows that the placebo effect can be greater
   and is far more ubiquitous than commonly thought.

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   One of the questions that skeptics are asked most persistently is to
   explain how acupuncture, homeopathy, faith healing, Qigong, and other
   treatments work. Skeptics often use the placebo effect-a response to
   the act of being treated, not to the treatment itself-as an answer, but
   usually to no avail. I believe that's because most people, both logical
   and fuzzy thinkers, don't truly understand what the placebo effect is.

   Spontaneous remission and the placebo effect, which are known as
   nonspecific effects, are significant phenomena that have great impact
   on consumers and health-care professionals. Recovery from illness,
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   treatment just because the improvement followed the treatment.

   H. K. Beecher's seminal paper "The Powerful Placebo" (Beecher 1955) is
   among the most frequently cited and was undoubtedly responsible for the
   double-blind study design having been adopted as the universal
   standard. Beecher reported on twenty-six studies and arrived at an
   average placebo response rate of 32.5 percent. From this figure comes
   the often cited statement that a fixed fraction (one-third) of the
   population responds to placebos. But this is a myth. A recent paper
   (Roberts et al. 1993) concluded that "under conditions of heightened
   expectations, the power of nonspecific effects (placebos) far exceeds
   that commonly reported in the literature."

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   without some level of nonspecific effects.

   A number of other myths are associated with placebos. Try to answer the
   following questions:
    1. Does a positive response to a placebo mean the patient's problem is
       imaginary?
    2. Does a patient have to believe in the therapy for a placebo effect
       to occur?
    3. Are placebos harmless?

   The answer to all three questions is no. Placebo responses can occur in
   patients with real disorders; the subjective symptoms can resolve while
   the objective ones remain. Belief in the treatment only appears to
   explain a portion of the placebo effect (Jarvis 1990). It appears that
   belief, operant conditioning, and suggestibility all play important
   roles. In an interesting experiment, a man experienced pain and
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   the power of suggestion.

   Contrary to popular belief, placebos can be harmful. Placebo responses
   can "teach" chronic illness by confirming and/or reinforcing the
   delusion of imagined disease (Jarvis 1990). Patients can become
   dependent on nonscientific practitioners who employ placebo therapies.
   Such patients may be led to believe they're suffering from imagined
   "reactive" hypoglycemia, nonexistent allergies and yeast infections,
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   realities is an unacceptable version of the 'double-blind.'"

   The use of placebos can undermine the doctor-patient relationship by
   requiring deception on the part of the caregiver. Consumer advocate
   Stephen Barrett has explicit reservations concerning overreliance on
   the placebo effect in clinical practice: "I am against people being
   misled. The quack who relies on a placebo effect is also pretending he
   knows what he is doing-that he can tell what is wrong with you and that
   he has effective treatment for just about everything . . . he is
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   need" (Barrett 1977).

   In addition, placebos "need not always be beneficial and may be frankly
   toxic: dermatitis medicamentosa and angioneurotic edema (allergic-type
   reactions) have resulted from placebo therapy. More subtle but equally
   important negative placebo effects must occur when the physician by
   virtue of a moment of inattention, a raised eyebrow, or a transient
   look of disgust, loses the trust of his patient" (Bourne 1991).
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     * Barrett, S. 1977. Health frauds and quackery. FDA Consumer
       11:12-17.
     * Beecher, H. K. 1955. The powerful placebo. JADA 159:1602-1606.
     * Bourne, H. 1991. Unrecognized therapeutic measures, including
       placebo. In Clinical Pharmacology, ed. by K. L. Melmon and H. F.
       Morrelli. New York: Macmillan.
     * Jarvis, W. T. 1990. Dubious dentistry: A dental continuing