Meaning, medicine and the "placebo effect".

"Moerman places the words "Placebo effect" in quotations because he believes that the placebo effect should be redefined. A placebo, he explains is inert. It has no causal effect. A more appropriate definition of the placebo effect he asserts is the "meaning response."

"It is because of our beliefs and the meaning we assocate with a placebo that determines its effectiveness. Despite this simple formula for determining who will respond to a placebo, it is not a very good predictor for a given individual at a given time. Studies show that there is no method to determine which individuals will respond to a placebo. Attempts have been made to remove placebo responders from studies. Occasionally, researchers will conduct a precursor trial run with a completely unrelated substance to indentify those who might respond to a placebo in an effort to cull these responders from the "real study". These attempts have been futile.

"No reliable indicators have ever been found that identify individual placebo responders. In fact, a person who responds to a placebo in one study has no increased likely hood of responding to a placebo in subsequent studies. More remarkably, if one eliminates the approximately one third of the populace who initially respond to a given placebo, the remaining group will contain about the same proportion of responders in subsequent studies" (David J. Kreiter).