Читать книгу Placebo: Mind over Matter in Modern Medicine - Dylan Evans - Страница 17

Dramatic claims have been made for placebos. According to Dr Robert Buckman and Karl Sabbagh, ‘they seem to have some effect on almost every symptom known to mankind’.¹ At the other extreme there are those who argue that the placebo effect is largely or even totally illusory. Arthur Shapiro, who spent forty years researching the topic from the mid-1950s until his death in 1995, concluded that there was little evidence for the view that placebos could have a direct and permanent effect on medical disorders.² Gunver Kienle and Helmut Kiene have probed the literature on placebos in great depth and found it to be full of misquotation, blind repetition of poorly substantiated claims and the uncritical reporting of anecdotes.³ The placebo effect, they claim, is no more than a myth.

So much for the claims; what of the evidence? It is true that placebos have been used in thousands of clinical trials, but – as we saw in the last chapter – most of these studies do not include a no-treatment group. As a result, we cannot be sure that the placebo made any difference. The improvement shown by the patients in the placebo group might have occurred anyway as they recovered their health naturally, even if they hadn’t received a dummy treatment. To discover what medical conditions the placebo response can really affect, we need to look at the research much more carefully. Only if it can be shown that people with a particular condition do better when treated with a placebo than when not treated at all can we be sure that the placebo response really works for that condition.