Placebos and Nocebos

D Balasubramanian, in his Speaking of Science column, describes some recent experiments on the placebo effect. The most interesting part of the story is about cheating (wihtout actually cheating), which, in turn leads to some interesting ethical questions:

Team C was given nothing in the first two sessions, but morphine in the third, and was shot with the same placebo on the competition day as Team B, but told that they too have been morphined.

The drug-in-practice Team C maintained its usual 21-22 second tolerance time even on the placebo-given event day.

Morphine is a performance-booster and is not allowed by the World Anti-Doping Agency (WADA) during sports competitions. However, it differs from drugs like steroids in an important way. Its action is temporary, lasting but a few hours. Steroids, on the other hand, build muscles and thus give much longer lasting effects. They are completely banned for sportsmen by WADA, but morphine is banned on competition days alone.

Benedetti asks: my volunteers did not use morphine on the competition day, yet their performance was better. Is placebo response then doping?

Are placebo responses ethically acceptable in sports competitions or should they be considered a doping procedure in all respects?

In the latter part of the essay Balasubramanian describes nocebos which are the opposites of placebos, and also some of the mechanisms behind the placebo effect. An interesting piece, and happy reading!


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