Placebo Case Study

Taking on the methodological explanation of the placebo posed by Holman, a placebo can be defined as a drug that causes all the same direct expectancy effects as the purported treatment, does not have any direct therapeutic effects, and also produces the same side effects as the supposed treatment.

Direct expectancy effect is experienced by an individual who expects something to happen because he or she is currently on a specific medication which might be the treatment. Indirect expectancy effect is a side effect that occurs because the subject thinks that they are taking the medication that one believes is the treatment, thus in essence, a placebo side effect. As expected, the direct treatment effects are the consequences experienced by taking

If the placebo causes all the same direct expectancy effects as the purported treatments, whether the patient is taking either the placebo or the treatment he or she should have the same expectancy effect in either cases. Having the placebo look, feel and/or taste the same as the treatment brings solidifies the blinding of the trial resulting in the direct expectancy effect since the patient is unable to differentiate. This placebo will create a similiar belief of effectiveness by these subjects compared to the treatment group, thus it decreases the chance of ruining the idea of a placebo controlled trial because if a subject knows they are receiving a placebo, the trial will lack its control component and the results may be skewed. The expectancy effect does not have to

It causes the same benefits as the actually treatment, however does not have any active mechanistic effect. However, the use of this placebo would be unethical and unpractical to be used in clinical practice. This is unpractical because in order for the expectancy effect to work, the patient must be unaware that they are receiving a placebo. This then weakens the trust in a doctor-patient relationship and in just plain unethical to not obtain informed consent which is required for this placebo to be effective at producing the expectancy effect. This also goes against the autonomy of the patient, where he or she is not able to be engage in the decision making process of what happens to their body. To conclude, the reasons stated above make this placebo use unethical and unpractical. The patients have doctor visit to be treated for diseases and not be part of clinical trials. To futher solidify my point of not using this placebo in clinical trials, the statistical analysis performed by Holman proved that persons who were receiving the treat and thought they were actually got better. Thus, the physician should just prescribe the treatment drug to the patient, where he can obtain informed consent assuring the patients that this drug does contain an active ingredient aimed at treating the condition.