The 130th Annual Meeting of APHA

Abstract #43391

Nadav Davidovitch, MD, Health Systems Management, Faculty for Health Sciences, Ben gurion University, P.O. Box 653, Beer Sheva, 84105, Israel, 972-50-465479, mikinadv@post.tau.ac.il

My paper presents a historical and philosophical analysis of the use of placebo by orthodox and alternative medicine practitioners throughout the 20th century. My main inquiry is how the image of the placebo has shifted from that of a treatment borne in suggestibility and deception – often called a “humble humbug” in 1940s medical articles – to become today’s powerful tool and crucial component of modern medical research. While the dialogue between orthodox and alternative medicine has been well established, the way in which it took form has changed throughout the history of medicine. In professional medical forums, contemporary discussions concentrate around the Randomized Clinical Trial, comparing the results of one group receiving a specific treatment with those of a second, a control group receiving a placebo. While orthodox medicine long claimed that alternative medical treatments are merely reflections of the placebo effect, the emphasis on the placebo as part of a sophisticated statistical methodology is a relatively recent phenomenon, originating mainly after World War II. At the turn of the 20th century, alternative medical practitioners, mainly homeopaths, were using placebos in their medical research, encountering an orthodox medical profession hostile to the use of statistics and the placebo effect. My claim is that a historical and philosophical analysis of the 20th-century use of the placebo, both as a medical treatment and as a research tool, can shed much needed light on the ethical debates precipitated by clinical trials, leading to a greater understanding of how scientific medical knowledge is ultimately produced.

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