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Medicine's inconvenient truth: the placebo and nocebo effect.
Intern Med J. 2014 Apr; 44(4):398-405.IM

Abstract

Placebo and nocebo effects are often regarded by clinicians as either a quaint reminiscence from the pre-therapeutic era, or simply as a technique for establishing the efficacy of therapeutic interventions within the locus of evidence-based practice. However, neither of these explanations sufficiently account for their complexity or their persistence and impact in clinical medicine. Placebo and nocebo effects are embedded in the very fabric of therapeutic relationships and are both a manifestation and outcome of the rituals that characterise clinical practice. They are also a stark reminder of the many personal and environmental factors, including the attitudes, beliefs and expectations of both doctor and patient, that shape the outcomes of health professional-patient interactions. We describe how recent biological and neuropsychiatric data have clarified the operation of placebo and nocebo effects in clinical practice - demonstrating the ability of the therapeutic context to modulate endogenous biological processes in a targeted manner. This, in turn, illustrates the potent philosophical and sociocultural aspects of medical praxis.

Authors+Show Affiliations

Northern Clinical School, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia; Centre for Values, Ethics and the Law in Medicine, School of Public Health, University of Sydney, Sydney, New South Wales, Australia; Department of Rheumatology, Royal North Shore Hospital, Sydney, New South Wales, Australia.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24754688

Citation

Arnold, M H., et al. "Medicine's Inconvenient Truth: the Placebo and Nocebo Effect." Internal Medicine Journal, vol. 44, no. 4, 2014, pp. 398-405.
Arnold MH, Finniss DG, Kerridge I. Medicine's inconvenient truth: the placebo and nocebo effect. Intern Med J. 2014;44(4):398-405.
Arnold, M. H., Finniss, D. G., & Kerridge, I. (2014). Medicine's inconvenient truth: the placebo and nocebo effect. Internal Medicine Journal, 44(4), 398-405. https://doi.org/10.1111/imj.12380
Arnold MH, Finniss DG, Kerridge I. Medicine's Inconvenient Truth: the Placebo and Nocebo Effect. Intern Med J. 2014;44(4):398-405. PubMed PMID: 24754688.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medicine's inconvenient truth: the placebo and nocebo effect. AU - Arnold,M H, AU - Finniss,D G, AU - Kerridge,I, PY - 2013/10/06/received PY - 2013/12/29/accepted PY - 2014/4/24/entrez PY - 2014/4/24/pubmed PY - 2015/2/5/medline KW - context effect KW - medical ethics KW - medical practice KW - medical therapeutics KW - nocebo KW - placebo SP - 398 EP - 405 JF - Internal medicine journal JO - Intern Med J VL - 44 IS - 4 N2 - Placebo and nocebo effects are often regarded by clinicians as either a quaint reminiscence from the pre-therapeutic era, or simply as a technique for establishing the efficacy of therapeutic interventions within the locus of evidence-based practice. However, neither of these explanations sufficiently account for their complexity or their persistence and impact in clinical medicine. Placebo and nocebo effects are embedded in the very fabric of therapeutic relationships and are both a manifestation and outcome of the rituals that characterise clinical practice. They are also a stark reminder of the many personal and environmental factors, including the attitudes, beliefs and expectations of both doctor and patient, that shape the outcomes of health professional-patient interactions. We describe how recent biological and neuropsychiatric data have clarified the operation of placebo and nocebo effects in clinical practice - demonstrating the ability of the therapeutic context to modulate endogenous biological processes in a targeted manner. This, in turn, illustrates the potent philosophical and sociocultural aspects of medical praxis. SN - 1445-5994 UR - https://www.unboundmedicine.com/medline/citation/24754688/Medicine's_inconvenient_truth:_the_placebo_and_nocebo_effect_ L2 - https://doi.org/10.1111/imj.12380 DB - PRIME DP - Unbound Medicine ER -