Trust in Placebos

Résumé

Trying to explain the placebo effect has forced researchers to consider human beings as a whole and not as the sum of their organs. Just as polluted particles in the air can make us cough, our own beliefs can make our symptoms disappear. Placebo effects operate through the socio-cultural beliefs that an injection, or a pill, is a healing agent in itself, independently of its actual constitution. These beliefs are naturally tightly linked to the meaningfulness of our environment. The white coat of the doctor, the hospital room, or words pronounced by an authority figure all have the power to create a physiological effect. The literature on placebos has not paid sufficient attention, however, to the meaning the patient assigns to her relationship to the doctor. It is plausible that there is a psychological difference between a doctor who is perceived to be both competent as well as acting with the patient’s well-being in mind as against the doctor who is perceived to be merely competent. That is to say, there is a distinction between trusting a doctor because we believe she cares for us and has our best interests at heart, as against trusting a doctor because we believe her to be merely reliable. Could this distinction make a difference in the context of placebos? In this paper, we develop the hypothesis that it could. We provide evidence from the literature supporting this hypothesis and suggest ways to test it. If correct, the hypothesis has implications not only for the theory of placebos but for healing more generally.