We were fascinated to see a story on Australia’s ABC News about recent research into the placebo effect. Pain researcher Damien Finniss, from Sydney’s Royal North Shore Pain Management and Research Institute, has published a paper in The Lancet on the phenomenon of the placebo effect. The ABC story makes two points which in our view have not received sufficient attention, namely:

* that the placebo effect is engaged even when a patient is aware s/he is receiving placebo (the ‘no-blind test’); and
* that responsible practitioners consider the agency of placebo in the course of treatment.

Consistent with other researchers we’ve read, Finniss and his colleagues are concerned with ethical issues in practitioner-client relationships in consideration of conscious engagement with the placebo effect. This is what we’d expect from responsible researchers and health professional. At the same time, we’re aware of anecdotal evidence and some research (contained elsewhere in this blog) that in any case there is widespread ‘de facto’ use of placebos in general practice and elsewhere, as for example in the presciption of an antiobiotic in the treatment of a viral condition.