Physicians commonly recommend ?placebo treatments?, which are not believed to have specific efficacy for the patient's condition. Motivations for placebo treatments include complying with patient expectations and promoting a placebo effect. In this article, we focus on two key empirical questions that must be addressed in order to assess the ethical legitimacy of placebo treatments in clinical practice: 1) do placebo treatments have the potential to produce clinically significant benefit? and 2) can placebo treatments be effective in promoting a therapeutic (...) placebo response without the use of deception? We examine evidence from clinical trials and laboratory experiments bearing on these two questions. The conclusion is reached that based on currently available evidence, it is premature to judge whether placebo treatments are ethically justifiable, with the possible exception of acupuncture for pain relief. (shrink)

Despite growing scientific interest in the placebo effect and increasing understanding of neurobiological mechanisms (Finniss et al. 2010), theoretical conceptualization of the placebo effect remains primitive (Miller, Colloca, and Kaptchuk 2009). Mechanistic research on this phenomenon appears largely free-floating, with little guidance by any systematic theoretical paradigm. A partial explanation is the pervasive conceptual confusion that characterizes thinking about the placebo effect. The philosopher of science Adolf Grunbaum noted that "the medical and psychiatric literature on placebos and their effects is (...) conceptually bewildering, to the point of being a veritable Tower of Babel" (Grunbaum 1994, p. 286). .. (shrink)

Among medical researchers and clinicians the dominant view is that it is unethical to deceive patients by prescribing a placebo. This opinion is formalized in a recent policy issued by the American Medical Association (AMA [Chicago, IL]). Although placebos can be shown to be always safe, often effective, and sometimes necessary, doctors are now effectively prohibited from using them in clinical practice. I argue that the deceptive administration of placebos is not subject to the same moral objections that face other (...) forms of deception in clinical practice and medical research. Although deception is normally objectionable on the grounds that it limits autonomy and breaches trust, these grounds do not apply to placebos when they are prescribed within appropriate ethical limits. Patients have reason to prefer that doctors can prescribe placebos in ethically responsible ways. Hence, the AMA has an obligation to endorse and to promote the responsible use of deceptive placebos in clinical practice. (shrink)

In Mind: An Introduction, for the first time John Searle offers a general introduction to the philosophy of the mind. Giving a broad survey of all the major issues under discussion in the field, including philosophical issues in cognitive science and neurobiology, Searle argues for his own distinctive point of view. He leads the reader through the variety of theories that reduce the mind to aspects that can be fully explained by physics, and then concludes with his own view that (...) such reductionist theories ignore or cannot adequately explain the most fundamental aspect of the mind - subjective consciousness. (shrink)

"The philosophy of mind is unique among contemporary philosophical subjects," writes John Searle, "in that all of the most famous and influential theories are false." In Mind, Searle dismantles these famous and influential theories as he presents a vividly written, comprehensive introduction to the mind. Here readers will find one of the world's most eminent thinkers shedding light on the central concern of modern philosophy. Searle begins with a look at the twelve problems of philosophy of mind--which he calls "Descartes (...) and Other Disasters"--problems which he returns to throughout the volume, as he illuminates such topics as the freedom of the will, the actual operation of mental causation, the nature and functioning of the unconscious, the analysis of perception, and the concept of the self. One of the key chapters is on the mind-body problem, which Searle analyzes brilliantly. He argues that all forms of consciousness--from feeling thirsty to wondering how to translate Mallarme--are caused by the behavior of neurons and are realized in the brain system, which is itself composed of neurons. But this does not mean that consciousness is nothing but neuronal behavior. The main point of having the concept of consciousness, Searle points out, is to capture the first person subjective features of the phenomenon and this point is lost if we redefine consciousness in third person objective terms. Described as a "dragonslayer by temperament," John Searle offers here a refreshingly direct and open discussion of philosophy, one that skewers accepted wisdom even as it offers striking new insights into the nature of consciousness and the mind. (shrink)