Synthese 194 (4):1363-1396 (2017)

Jeremy Howick
Oxford University
Debates about the ethics and effects of placebos and whether ‘placebos’ in clinical trials of complex treatments such as acupuncture are adequate rage. Yet there is currently no widely accepted definition of the ‘placebo’. A definition of the placebo is likely to inform these controversies. Grünbaum’s characterization of placebos and placebo effects has been touted by some authors as the best attempt thus far, but has not won widespread acceptance largely because Grünbaum failed to specify what he means by a therapeutic theory and because he does not stipulate a special role for expectation effects. Grünbaum claims that placebos are treatments whose ‘characteristic features’ do not have therapeutic effects on the target disorder. I show that with four modifications, Grünbaum’s definition provides a defensible account of placebos for the purpose of constructing placebo controls within clinical trials. The modifications I introduce are: adding a special role for expectations, insisting that placebo controls control for all and only the effects of the incidental treatment features, relativizing the definition of placebos to patients, and introducing harmful interventions and nocebos to the definitional scheme. I also provide guidance for classifying treatment features as characteristic or incidental
Keywords Philosophy of science  Methodology  Placebo  Randomized trial  Grünbaum  Philosophy of medicine  Ethics
Categories (categorize this paper)
DOI 10.1007/s11229-015-1001-0
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 62,242
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

The Philosophy of Evidence-Based Medicine.Jeremy Howick - 2011 - Wiley-Blackwell, Bmj Books.
What Evidence in Evidence-Based Medicine?John Worrall - 2002 - Proceedings of the Philosophy of Science Association 2002 (3):S316-S330.
What Evidence in Evidence‐Based Medicine?John Worrall - 2002 - Philosophy of Science 69 (S3):S316-S330.
A Duty to Deceive: Placebos in Clinical Practice.Bennett Foddy - 2009 - American Journal of Bioethics 9 (12):4-12.

View all 15 references / Add more references

Citations of this work BETA

In Defense of Meta-Analysis.Bennett Holman - 2019 - Synthese 196 (8):3189-3211.
Meaning and Affect in the Placebo Effect.Daniele Chiffi, Ahti-Veikko Pietarinen & Alessandro Grecucci - 2021 - Journal of Medicine and Philosophy 46 (3):313-329.
An Enactive Account of Placebo Effects.Giulio Ongaro & Dave Ward - 2017 - Biology and Philosophy 32 (4):507-533.

View all 10 citations / Add more citations

Similar books and articles

Why Most Sugar Pills Are Not Placebos.Bennett Holman - 2015 - Philosophy of Science 82 (5):1330-1343.
Semiotics and the Placebo Effect.Franklin G. Miller & Luana Colloca - 2010 - Perspectives in Biology and Medicine 53 (4):509-516.
Impure Placebo is a Useless Concept.Pekka Louhiala, Harri Hemilä & Raimo Puustinen - 2015 - Theoretical Medicine and Bioethics 36 (4):279-289.
‘Placebos’ and the Logic of Placebo Comparison.Andrew Turner - 2012 - Biology and Philosophy 27 (3):419-432.
The Ethics of the Placebo in Clinical Practice Revisited.P. Louhiala - 2009 - Journal of Medical Ethics 35 (7):407-409.
Placebo Controls and Epistemic Control in Orthodox Medicine.Mark D. Sullivan - 1993 - Journal of Medicine and Philosophy 18 (2):213-231.
From Medicine to Psychotherapy: The Placebo Effect.Stewart Justman - 2011 - History of the Human Sciences 24 (1):95-107.
Exploiting Placebo Effects for Therapeutic Benefit.Colin Cheyne - 2005 - Health Care Analysis 13 (3):177-188.


Added to PP index

Total views
110 ( #96,524 of 2,444,761 )

Recent downloads (6 months)
9 ( #76,839 of 2,444,761 )

How can I increase my downloads?


My notes