Table 1.

Historical conceptualization of “placebo” and “placebo effects” in the clinic and research.

Clinic	Research
The placebo has “fake” effects a	The placebo has “real” effects
- They are psychological (product of the patient’s imagination)	- Some effects are even physical and can mimic the action of a drug
The placebo effect is “benign”	The placebo effect is “dangerous”
- It is “better than nothing” and is unlikely to harm	- It threatens to obscure the effects of legitimate biochemical compounds
The placebo pill’s purpose is practical	The placebo pill’s purpose is epistemological
- To please the patient and make the doctor’s life easier	- To control for this precisely real and powerful effect
By the 1950s, the use of placebo was unethical	By 1950s, the use of placebo was ethical
- The deceptive use of placebos violates patient autonomy, shared decision-making, and informed consent	- The use of placebos for blinding is justified and necessary in research

^aThe terms “fake” and “real” here are used as a hyperbole to situate historical thinking about the mind versus the body. Nowadays, it is understood that psychological and biological forces are two sides of the same coin, the former being just as “real” as the latter.