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Howick et al. beg the question

Posted by Leigh_Jackson on 21 Jul 2013 at 09:22 GMT

The distinction in Howick et al. between "pure" and "inert" placebos leads the authors to conclude that the use of placebos is widespread. The term "inert placebo" as employed by Howick et al. is paradoxical since they use it to refer to treatments that are not pharmacologically inert. Hitherto, by definition, a placebo has been understood to be a pharmacologically inert substance employed as a treatment for psychological reasons or as a control in clinical trials.

The authors do not justify their new terminology, they adopt it by fiat. Their study does not present evidence of widespread use of "pure" placebos: Which is to say, placebos as hitherto understood are not in widespread use. It is their new category of "inert" placebos that are not inert, which are found to be in widespread use: Treatments not hitherto considered to be placebos at all.

The authors must justify the paradoxical extension of the term "placebo" to include pharmacologically active treatments, in order to justify their claim that placebos are in widespread medical use.

No competing interests declared.