James van der Walt

Social Entrepreneur, Ugesi Gold

This conversation is closed.

I have an ethical question. Is it wrong to use placebos?

I'm starting a rural business. Most of these people are very poor and even cynical about their situation. Now I have a plan to start businesses and learning but I first have to get past the mind set. If I were to offer a placebo pill that helps with "your finances and success" would that be wrong?

The idea is that with the business plans I want people to think that they CAN do this. To fight the ideas of "That this is too complicated or that it's just going to fail anyway". Placebo works on the mind but it's power lies in deceit or believe (maybe even faith). So is it wrong to tell people that this pill will help them get out of this bad situation (together with the community projects I have in mind)

Closing Statement from James van der Walt

Thank you all for a very good discussion to get a clearer view of what a placebo means. Also thank you Sietse Sterrenburg for the article you posted. I think it shows clearly what this discussion was about.
http://www.ted.com/conversations/6494/i_have_an_ethical_question_is.html

So in conclusion. A placebo is a trick to make your mind think you are being healed which then enables your to heal naturally. But this effect is based in deceit which is not ethical. It is much better to train people to use the power of their mind to get the same effect. The placebo has nothing to do with you getting better after all. Rather embrace the truth and enable people to help themselves.

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    Oct 21 2011: When you give medication or a treatment to a patient, you need to get informed consent which means that the patient understands why he/she needs it, what the side effects will be as well as the risks involved. Administering a pill without the patient's informed consent is wrong. Patients taking part in clinical trials are informed that they may receive the drug being tested or they may be part of the controlled group receiving the placebo; they consent to this and sign a document fully understanding what is being done. The people you are referring to would be considered 'lied to' and have not taken part of an informed consent consultation. Lying is certainly not a good way of building a rapport with these people. Secondly, have you considered the secondary effects of this placebo as well as the primary? Your hypothesis for the primary effect is that the person will feel happy, optimistic, motivated and successful. The secondary effects would include confusion, depression, misdirected blame (should the person not achieve the desired results). What then would you say to this person when they ask you, "why is this not working?"
    • Oct 21 2011: :) Was just about to post almost exactly the same argument.

      And if the secondary effects make them angry enough, they maybe even won't ask "why this is not working", but put their anger into action. Sure enough you don't want to be around then...

      A placebo is by definition something that's chosen to test potentially helpful solutions because it's known to have no effect on the situation in question.

      If you really want to help people be successful, give them meaning of life. There are no pills with meaning of life inside them, though...
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      Oct 21 2011: Very well put.
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    Oct 21 2011: Actually you can be open about it being a placebo and it will probably still have the same effect. At least that's what I expect based on the study that showed exactly that: http://blogs.plos.org/neurotribes/2010/12/22/meet-the-ethical-placebo-a-story-that-heals/
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      Oct 21 2011: Dear Sietse, Thanks so much for posting such an interesting and really relevant article. It really illuminated the issues better than anything else I have read on this subject so far. Please keep posting such high quality information!
  • Oct 21 2011: " I was brought up a Christian but as I got older I got the cognitive reasoning to think for myself and I no longer need the blind believe. That said I believe most people are not at this level yet."

    Aside from the ethical question, what disturbs me is the condescension. The idea that these "rural" people can't use their brains and learn. And the idea that all faith is unintelligent and un-investigated. There is a mountain of evidence: historical, archeological, and scientific that has led me to my faith. Someone else may choose to ignore those facts or choose to interpret them in a different way, but it's extremely arrogant to dismiss it out of hand when you haven't looked at it yourself in an honest, scientific way.

    And I think it's pretty arrogant to decide these rural people can't see their way to success without some placebo. Granted, it might be harder and take more time to actually work with them, get to know them, and encourage them. But it would certainly lead to a better chance of long term benefits. It's a dangerous thing to play with people's minds and lives and beliefs.

    I'm glad you want to help others. But it will do more harm then good to slap a bandaid on the issue. Better to get at the root of the problem. Quick fixes seldom work in the long run. They usually fall apart. And then, these people will be left even more bitter and cynical.
  • Oct 21 2011: Research has proven that placebos work even when test participants are told that they are taking a placebo. Deceit is unnecessary to achieve the placebo effect. It's all about the story. Persuade them with the true story that while the content of the pill is inert, the mind and body can be trained (like Pavlov's dogs) to respond to the visualization of success, the belief in it, that they focus upon two or three times each day when they take their pill. Emphasize that the visualization/belief must accompany each ingestion of a pill, and instruct them to take the pills at the same time each day. Or don't use a placebo at all, just persuade them with your confidence, or better yet, your evidence.
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    Oct 21 2011: This is a very old prescription, it was called talisman or amulet.
    The real medical treatment often works the same way but is much more expensive.

    The deceit is in the provider of any placebo.
    Is it given wise and from love, I would call it care, is it given greedy from an selfish interest perspective, I would call it fraud.

    Whether it is ethical or not you can only search your heart.
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      Oct 21 2011: Thanks Frans. That's exactly my point. It comes down to intention.
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    Oct 21 2011: I think it's morally wrong, even if the intention is good. Inducting superstition cannot possibly be the best solution.
    When you raise your kids, you can have them behave using fear of Hell, or you can have them understand moral implications of their behaviour. The first one is easy. "Do this or the Boggeyman will get you", this requires no educationnal skills.
    "Take this pill and you'll be happy", is the same kind of easy trickery. You could make an easy living and probably make people happy with the placebo effect, but in the end, they will have learnt NOTHING, and would not know what to do if they ran out of magic pills.

    Cause, yeah, you'd be creating a dependance as well.
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      Oct 21 2011: The dependence is all in your head. I was brought up a Christian but as I got older I got the cognitive reasoning to think for myself and I no longer need the blind believe. That said I believe most people are not at this level yet. They want to believe as Michael Shermer pointed out. We want to believe is something. Using peoples very nature to guild them from ignorance... is that bad? There's no reason why after some success not to just tell them is was a placebo and they had the power all along.

      The question is... Is believe wrong?
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        Oct 21 2011: Yeah just like Santa Claus. You don't hate you parents for having lied. It was your nature to believe in flying reindeer. But if your parents used Santa's omniscience as leverage, they were failing at explaining to you why anyone had to behave.

        So belief is not wrong, but it shouldn't be used if something better is available.
        It's ok to believe the sun's going around the earth until you have a better explanation available, for instance. In our case, there are surely better ways to be found to increse happiness in a poor community.
        • Oct 21 2011: What is the difference between believing in Santa Claus or in Science? Surely you're going to tell me Santa is a human invention, and Science is a method of learning about our Universe. However, we know for sure that Santa does not exist, but in the same way we know that all the latest scientific theories are mere hipothesys in wich we believe (or have faith?...). And most of them, if we go to the sub-atomic scale or the cosmological scale, will hardly be proven in our lifes. Our belief in Science is very close to faith, but we deny faith in anything else than Science.

          If the placebo effects are proven, I would surely like them to be used in a moral way to improve quality of life, in the same way I would like Science to be used for the same purpose. I cannot see any difference in deceiving the human mind to make it more powerfull in solving its problems than in creating biological problems to solve diseases, like we do with antibiotics, for instance...

          I agree in what you say about the need of learning the ways to be happy, rather than be given a magic solution. However, Science and education are not solving these problems we are talking about. It is really a question of level of inner development of societies and individuals, and I really believe that development can only be learned, never taught...
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        Oct 21 2011: Your conception of science is absolutely wrong.
        But I don't believe you. Make an effort, I know you can guess what science does differently than story tellers.
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    Oct 22 2011: Yes, it is wrong if you actually misrepresent what the pills are and what they can do. However, if you pass out multivitamin tablets, and tell them something along the lines of, "These pills contain vital elements that are known to help with cognition, and strength, and health, and vitality, which can help prepare you for prosperity", then you have told the truth about the vitamins, and given them something to pin their bigger hopes and dreams on.
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    Oct 21 2011: This is the magic feather syndrome from "Dumbo" and it is an totally appropriate way to proceed. The fact is, we have this theme in our stories ("You had the power all the time Dorothy") in every culture for a reason. The linear mind can only imagine what it has already seen to be true, and the best and simplest way to bypass that predjudice is to introduce a "magical" agent.
    It is true that the same tool can be used for "evil" and in fact, pyramid schemes and get quick rich shemes are largely based on the same proposition. Even "housing prices always go up" could be argued as dependent on this principal. But so long as you are employing your placebo to assist others in gaining thier OWN dreams and goals and not enslaving them to your dreams or goals, I would say you are in the moral clear.
  • Oct 22 2011: Presentation is everything here so as to not make this deceitful. Perhaps if you approach this community and tell them "this is an experiement and some of you will get the real thing and some of you get the placebo" ?, or something like this that would be the most honest way you could apporach these people and still try to provide the help it seems like you're intending.

    Frankly, I think placebos are great--alot less side-effects and they show the true power of the mind!
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    Oct 22 2011: Dear Debra where are you....nice to see you again.

    The placebos is a field so complex because the theraphy is done (in some cases and for some illness) very effective...certainly in others situations are usless and the real intervention from surgeons and doctors are unavoidable. Placebos and faith cames together. But touch the ethical field if the placebo is a dirty and cheap trick.

    We have to be aware to see de real difference betwen placebos, remedies, natural medicine and alopathy.
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    Oct 22 2011: I see no ethical issue here. If you say "take this pill and you'll be able to do X", and then because of the experience they take the pill and do X, surely you have delivered the product you promised. I don't see why you would need to explain every aspect of how the product works if doing so would reduce its effectiveness.
  • Oct 21 2011: In these days i worry less about the potential good that a placebo can do than i do about how some companies try to debunk good medicines that actually do work. We now live in a time where doctors and patients understancd that some medicines have side effects but are still forced to face the very real questions of "Quality of life" vesus "Quantity of life". However, when one company exploits that situation, spurred by news sound bytes, to bring about litigation or even the hint of it....then thats, to me, is more reprehensible than the relief that a placebo could potentially bring.
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    Oct 21 2011: I think there are many examples of the power of the mind to overcome obstacles with the use of a placebo. There is definitely evidence of placebos helping medical conditions possibly by reducing stress and allowing the body to better cure its self.
    So I would ask the opposite question. If you have a placebo and by some means you could be sure that the placebo would help cure a person. Or in your question if a person has a negative outlook and you know that some placebo will help them.

    Is it ethical NOT to give the placebo. Because if the belief is something is what a person needs, and a placebo will achieve that. Then in actual fact it is not really a placebo. It is a device to effect a physical or mental change by unconventional means.

    Say a person is taking a homeopathic medicine and getting better from a serious illness. You prove to this person that homeopathy is a scam, they lose their belief, get depressed, and they get ill again. Was that ethical?

    I believe that many alternate treatments work because they give the patient hope and that allows the bodes own healing to work more effectively.

    At the end of the day if what a person needs is to believe in something, so that they can believe in themselves I say give them what they need.

    Successful people often cary a rabbits foot, or a lucky dime, or some other amulet that gives them strength.
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    Oct 21 2011: Morality is subjective. Morality changes from place to place, culture to culture, religion to religion and changes over time. Morality is normative and relative.

    You might be able to use the model of utilitarianism, in that what does the most good for the most amount of people could be used as an argument for a moral action.

    You could use the theory of consequentialism whereby the morality of an action is based upon the good outcome of that action. If the consequences are "good" then it doesn't matter what the action is per se. What is "good" though? Good for who?

    My own personal belief is that as long as you do not profit from this and no one gets hurt, as long as your intentions are pure and will benefit the people who are taking the placebo, then it is not an immoral action by my definition. However as I mentioned from the start, morality is normative and relative which you have to ascertain from your own society, social mores and culture.
  • Oct 21 2011: I think you have answered your own question. The pill is the same as the religion analogy. It may seem well and good to teach people that they are good, special, and capable individuals. As you came to realize that religion, your pill, was full of flaws you rejected it for a different path. Ask yourself why you did that despite the benefits? Seems like that deciet was too big a pill for you to swallow.
    You can't make a horse drink water no matter how much you think it needs it. You can't explain it to the horse as you speak different languages. The same it is with the people you are talking about. You don't speak their language, know their culture or really understand what they know and understand. If they are not ready to change then your job is to accept that and be there for them anyway.
  • Oct 21 2011: I find it wrong and I think poverty is more often than not caused by a lack of opportunity. I would also try to understand the mindset first. If you want to help and do have the means trying to listen first, then to educate would probably bring more.
    One good example: http://www.ted.com/talks/bunker_roy.html
    Your business is more likely to flourish if it's based on trust.
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    Oct 21 2011: Fascinating question, I think about the placebo effect quite a bit as the whole alternative medicine industry runs on it.
    You will have to lie.
    Lying kills trust.
    Dont do it.
  • Oct 21 2011: Absolutely wrong. Placebos make people think something curative happened when it didn't. They will then turn down actual remedies. Having just been through heart surgery, I speak from experience. Compassion & attentiveness plus treatment. No bullshit.

    http://www.guardian.co.uk/science/blog/2011/oct/11/placebos-reiki-cancer-patients-harm
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      Oct 21 2011: Hi Pete!
      The article that Sietse posted above is really excellent for clarifying these issues and I think you might enjoy it.
  • Oct 21 2011: It sounds like a shortcut to connecting with these people on a genuine, trust-based level. If you are starting with deception, where do you go from there? I feel the placebo discussion is a straw man. There is a reason we teach our kids about Santa Claus...cause and effect...you can't get something for nothing...please stop pulling the dog's tail. The only thing you would be teaching these people is that the answer lies outside themselves, not within them. And what message does it send if it doesn't "work" for them? It seems your heart is in the right place, but there is no shortcut to real trust, or positive self-worth, and you may do more harm than good with such a "placebo"...P.S...as someone else said, google "nocebos"
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    Oct 21 2011: Why use the term "placebo" at all? Can you not write a plan that is clear, simple and concise? As others have pointed out the power/success lies within the individual. You have given very little information about what you are asking about that it is near impossible to reply with anything but advice/platitudes. Is your idea multi-level-marketing? If so, IMHO, I'd say find something else to do and so very few in the downline will see any return at all, except for frustration and anger. If you are genuinely seeking to help individuals/community I suggest that you take a look at and study Catherin Austin Fitts at http://solari.com/blog/. She is one of the most brilliant women in the world and knows the world of finance from the small to the very large
  • Oct 21 2011: While placebos are presented as a means to trick the mind, there is no reason they should be discounted as a means to an end. In my thinking, placebos underscore the inherent power to heal to which we Westerners have been blinded (by science et al that or who profit). The placebo effect is a glorious reminder that we can indeed do and be much more than we ever thought we could. My advice regarding your project, make certain you have an honest placebo that produces unquestionable results as opposed to promoting inspirational lies that are meant to sell your product.
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    Oct 21 2011: The power of a placebo isn't necessarily in its deception. Placebos work because of belief. Belief in the placebo effect has been shown to still be effective. I'm not sure if it is as effective, as it is dependent on the strength of belief in the subject. However, it may be beneficial to know.

    http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0015591
    http://www.newscientist.com/article/mg21128271.600-heal-thyself-the-power-of-mind-over-body.html

    The fact that you're questioning this suggests that you genuinely care. I see a few options for you:
    (1) Be non-transparent; hide the placebo in a contract.
    (2) Be semi-transparent; reveal the possible use of a placebo.
    (3) Be entirely transparent; reveal the use and the value of placebos. Success would be much more dependent on an individual's situation and how compelling you are.
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    Oct 21 2011: With all due respect Mr. Van der Walt. I don't believe one can apply the same logic to an "economic or financial" placebo, as a placebo utilized for medicinal purposes. The human mind has an immeasurable potential to heal the body, but when dealing with finances, I think you have to work with your potential clients to educate them. The body controls itself. Finances have so many variable influences that are beyond the individual's control. I believe that the "financial placebo" may be a root cause of the unprecedented housing bubble in the United States that rocked the whole world when it popped. There is too much of "Just sign here, and you'll be happy" in the financial industry already, but I am not educated in economics, finances, or business. I'm just explaining how I observe it, and applying my limited knowledge to your question.
  • Oct 21 2011: Its very difficult to say that intention can validate this reasoning. If there are to be any standards whatsoever, then intention throws them out the window. After all, your intentions may differ from those of Person Z, but to what standard are both of your intentions to be compared with to determine that they are "moral?"

    I understand your desire to help people achieve success, but I have a hard time believing that trickery is the answer (even if you do tell them later). What people do, they do of their own accord. That being said, there are no choices that an individual can make that is not their own personal choice. A person can be convinced, tricked, manipulated, inspired, coerced, or whatever; but in the end, whatever choice that person makes is due to their own volition.

    Understand also what the negative effects could be. These are more than likely going to be psychological if there are any at all. But I think most people can relate to doing things out of good intention and having them completely backfire. I realize that this is assumption, but I think it is a very human thing to do. But I also think that learning from mistakes is also a very human thing to do, and one that should not be overlooked or forgotten.

    Achieving success by having been tricked seems like it would induce a very degrading feeling.

    If you truly want to help people achieve success, inspire them. Have faith in them. People are not cattle in which to be toyed. If they already have the ability to achieve success, convince them. Don't trick them with a product and then tell them later it was for their own benefit.
  • Oct 21 2011: I think placebo pills work for medical conditions because you expect a pill to solve a medical condition. If you tried to give me a pill with the claim it will fix my financial situation I'd lose all faith and trust in your ability to help me with my business planning process. I'd then tell my friends about this guy who actually tried to sell me on a pill to help me with my business. It doesn't make sense. I'm not really sure where the ethical consideration comes in... maybe in the assumption that a person could be so blind as to believe a pill will solve their financial woes. If you genuinely want to help people find success, I would think you need to first identify what their problems are, relate to those problems by providing an example of someone who over came them (ideally yourself) and then show them the best route to get from their present troubling situation to their goals. Providing them some false, superstitious talisman or whatever, just seems... gimmicky. And kinda shmarmy. And, should their business fail because they relied solely on rubbing the talisman three times a day while hopping on one foot... well, there goes your credibility. Cynicism is definitely a hurdle, and a difficult one to jump, but there must be a better, more reliable, way to address that.
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    Oct 21 2011: No-- but the question you raise is based on a flawed premise, namely that placebos are a deceit of some kind. The so-called placebo effect has been well documented and studied. It has been shown that even 1/3 of cancer patients experience improvements in their condition from placebos. Every medical study has a control group to balance out the placebo effect.

    So why do we keep making new pills when we haven't figured out how the mind acts on the body?

    The placebo effect is a scientific fact. We know that what a person thinks and believes about themselves and their conditions can create changes with in the body. But still instead of studying how we can use this relationship proactively, we brush it aside because we don't yet understand it. It becomes an anomaly we must factor out of our research, rather than an avenue of treatment.

    Let's look at it another way... if I could give you a pill that would hypnotize you into believing that you were incapable of failure, and that any failure you encountered was only a minor set-back on the way to your grand and inevitable success, would you take it? And if you did take it wouldn't you work all the harder? Wouldn't your life end up being more successful because you never doubted that it was so?

    What if the inverse of this was true? Try doing a web search for "nocebo."

    "Placebo" is just the scientific communities word for "we know that perception effects reality, but we can't explain it, so we figured out a way to ignore it"

    http://s3.amazonaws.com/data.tumblr.com/tumblr_ltdtgsKIM81ql6h4fo1_1280.jpg
  • Oct 21 2011: James:

    I am Biologist and Graduate Student of Depth Psychology. Years ago I was a drug rep for Upjohn and sold against a Merck's product called Vasotec. Clinical trials were SO effective in preventing CHF (Congestive Heart Failure) that is was considered UNETHICAL to use Placebo. During that last TEN years I have been a business consultant working with small business owners and individuals who WISH to start their own business. MOST of the challenges ARE, personal and psychological, however, 9 out of 10 start up FAIL due to stepping outside of ones area of expertise and/or the ignorant notion that if you "build it they will come." Success is RARE not normal. WE are trying to NORMALIZE success when only 2.5% of the population is GEARED for innovation. 80% of the population is CONSUMER minded and interested in just "chilling" and "working a job." Good luck on your effort James "of the World." Enabling vs empowering is the subject. Keep in mind 75% of the wealth in the US is in the hands of people OVER the age of 55. 90% of college students are Boomerangs, returning to the nest of the same people over 55 that don't have jobs anymore either. LYING to people is a BAD idea. You can lead a horse to water but if they do not THIRST they will not drink. Help yourself. Lead by example. Follow YOUR Bliss and they will find theirs. Jung said "Who looks outside Dreams. Who looks inside Awakens." Wake up NEO. Taojonz!
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    Oct 21 2011: Intention is an aside. Sure intention CAN be important in moral questions but this dilemma has two problems which must be faced before we get that far.

    First, you are perpetuating a false paradigm. Namely you are supporting the false notion that there exist magic pills that can solve all of our problems. Yes, there are pills which are curative in some measure and circumstance, but we do not have the kinds of magic bullets people imagine exist. This is a kind of deception in and of itself.

    Second, If you are making certain claims about your product (whether a pill or otherwise) and you KNOW those claims are untrue you are deceiving your audience. You SAY it is for their benefit, but I suspect you intend to charge something for your services so in the end it is YOU who benefits from the deceit.
  • Oct 21 2011: Suppose, just suppose, that God is. Beyond the limitations of definition. Beyond the labels and the stories. Just suppose God is. That God exists in some form or fashion. Is it plausible that God might be experienced as some sort of organized energy? Suppose lining up with that energy can produce physical results. It's possible, right? Suppose belief (or faith) is the mechanism for aligning the energy. Suppose you could move a mountain if you knew how to do it right. In light of all that, if those premises were true and founded in the laws of Newton and clearly within the realm of reality and reason - in that light, what IS a placebo?
  • Oct 21 2011: the illusion of 'science' is often that it's fact...as Gerald pointed out, the 'science' of the day based in people's regular experience (sun comes up over there and goes down over there - hard to argue with) was that the sun revolved around the earth..when coupled with a belief system that asserts earthcentricity it appears as fact. however all beliefs are constructions of perception. (and whether we like it or not science is just one more belief system however rational we want to make it look)

    remember we're potentially upgrading our theory of relativity in the face of the latest experiments with neutrinos going faster than the speed of light. and if it proves to be true, (at least for now) then the entire belief of relativity despite mathematical 'proof' is subject to change...so does it have any more validity than a superstition? I'm not so sure...

    it's a perception of the moment based in our current limited capacity to see what we see from where we're looking. And the double slit experiment has already indicated that the observer affects the reality. how is all that any different than giving someone a placebo that may produce the results? science 'produces the results' until it doesn't an history is rife with scientific upgrades as new capacities and capabilities are explored.

    the ethics are simply...if you're misleading someone , especially but not limited to 'for profit' then for me it's unethical...however if it works, then are you misleading?
  • Oct 21 2011: I dont believe its unethical to provide a placebo. We could imagine placebos as our perception of events or actions that happen in our lives, ones that arent pills and we usually consider ethical.

    great question, makes me think.
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    Oct 21 2011: As someone who deals with a medical condition, placebos are a must. The human mind can be one's best friend or own worst enemy. As human nature dictates, when we perceive ourselves to be right, we are never wrong.

    Placebos offer a way for a person to visit the truth behind their beliefs and discover if it really helps them or not.

    If your intention is to deceive so that you succeed and others fail, and only you know that, then you are violating ethics. The power of a belief system can lead one to ultimate failure or success. That said, are you labeling something a placebo, but in fact, it is an attempt to deceive for personal wealth? Two different things. What do you offer someone after they find out it is a placebo?

    Steven
    Voice123
  • Oct 21 2011: Well, to begin with I personally wouldn't believe that such a pill could actually work.
    But if the results are good and people use it out of their own free will, I don't see a problem.
    Naturally it does appear to be a snake-oil remedy, but people always have a choice...

    Either way, I still believe in hard work, compared to any kind of pill.
    Patience and steady growth vs. fast money and fast influx.
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    Oct 21 2011: Do you not believe that educating the community is better than attempting to placebo them into acceptance of your ideas? It seems morally questionable to me because the thought of using a placebo seems to assume that the people aren't capable of or willing to learn.

    "So is it wrong to tell people that this pill will help them get out of this bad situation (together with the community projects I have in mind)" My answer would be "Yes. It is wrong. Take the time to build community support that is based on the truth."
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    Oct 21 2011: here is my ethical viewpoint.

    1. you are free to offer whatever services or products you can come up with.

    2. every transaction is a contract. you pledged to provide some service to the other party. if you don't deliver what you have promised, it is fraud, and you have to compensate for any damage you caused (including but not limited to the price of your service).

    3. an actual effect is different from the effect of the belief that there will be some effect. that is, real efficacy is different then placebo. you can promise placebo, and you can promise real effect, and you can promise nothing. it is up to you.

    4. if you offer real effect, but you actually deliver placebo, you commit fraud. thus people can rightfully ask their money back, and ask for compensation for any damage they suffered as a direct consequence of your fraudulent behavior. this applies even if they've actually became more successful.

    5. offering a real effect can be done in may ways. not only direct promise counts. if you say "hey man, this is not scientific, but i gave this stuff to X, and he is now successful", it is still fraud, because according to normal communication standards, it implies a causal relation. otherwise, this statement would have the same validity as "i said abracadabra and he is now successful" or even "i ate hamburger yesterday, and now he is successful". these are silly statements. we assume if you bothered to say this, you were not just bubbling, but implied relationship.

    6. if you somehow manage to offer your product without promising any effect of it, i see no ethical problem. even if you know what they believe and what they want. and even if you know that they might not or will not achieve their goal. in this case, your contract does not include any effect.
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      Oct 21 2011: But Krisztian, I thought this was a moral issue, not one about what you can get away with.

      Also, placebo doesn't work if the guy taking the pill doesn't get the idea from someone that it will actually make him happier, or sadder or sick. "Not promising results" is a trick and only gives the ILLUSION that he's lying to himself. This is not ethical.
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        Oct 21 2011: i was talking all about moral.
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          Oct 21 2011: Then please explain your 6th point, as I seem to have misunderstood what you meant.
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        Oct 21 2011: for example if you live in a society in which there already is such a superstition, or someone else spreads this false belief. i don't think that selling homeopathic remedies is unethical. saying they work is. even hinting it is. but just selling is not.

        so if our questioner here finds a kind of animal organ or plant that already is associated with success in life, selling it is perfectly okay as long as he does not even suggest it would be beneficial. selling dried powdered cock's heart for example is very much ethical. just don't call it "success powder".
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          Oct 21 2011: Hmmm... I'm puzzled.
          Even if you're not harming anyone with this, and even if the belief was already there, it still doesn't seem right to me to sell superstition.
          It's ok if you're Polynesian to sell magic Tiki and fake to believe in its good luck power. Or Jing Seng for potency if you're a peasant living in Western China. But damn, we're the West. We carry the fire of rationnal thinking. If we lay low and keep our mouths shut about astrology and homeopathy, who's there to prevent it from going too far?
          The reason why the cure for AIDS will come from the West and not from Africa, even though it's more needed there, is because we've gradually got rid of superstition in part of our institutions and they're still stuck with it. We should be active against anything slowing down inovation.
          And on a more parochial level, magic pills can distract from solving real problems.

          So OK, it's not utterly wrong. But isn't it a duty?
        • Oct 21 2011: Krisztian: Doesn't your position on this kind of amount to : It's okay to do 'a certain thing', just do not self-promote the product/service as helpful...?
          Therefore, a sign in a storefront that reads " we sell hand guns" is acceptable...?
          Whereas a sign which reads "Our handguns always hits the heart" is not,
          Simply because, like the placebo, if offers a null effect, only promise?
          And isn't a placebo just the 'permission' for one to allow a possibilty, a dream of inprovement...(in whatever respective field)...?
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          Oct 22 2011: Can't see any justification for what you are proposing. You should read "The Constant Gardener"
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      Oct 21 2011: Fraud, that is exactly what it comes down to. Just like Be Goldacre pointed pharmaceutical companies are doing yet since the numbers are fudged they can just explain away anything. "For a small 1/2 of the time you are guaranteed a 100% success rate!!"

      In fact this same model of believe has been used for years by religions across the globe. You're promised salvation, all you have to do is this and this and put your faith here. This is an extremely powerful tool that can be used for both good and evil. I just watched a talk by Michael Shermer about how people want to see a pattern. We want to believe in things. It's our nature.

      So back to the placebo effect. I'm sure if you tell people this pill will help you be more successful with the help of joining this community program, they will accredit the success not to their hard work but to this little useless placebo. Sure after they've actually made a difference you can tell them it was all them and they had the power all along. The program is about making them believe in themselves.

      I'm reminded of the movie Watchmen where the world believes they've been attacked by an alien and they all unite and stop attacking each other. It's peace bought by deceit but peace none the less.

      Many evils have been done because of blind belief because you can get people to give you their money and even their lives. But it's just a tool. If you can convince someone to stop selling drugs and join a program that will help them make something of their lives who's to say the end does not justify the means. People find it much easier to believe in some great force than in their own inner power. Why would it be wrong to use our human nature to steer people in the right direction for a change. The evil people will continue doing it anyway (and get away with it), why not fight fire with fire?

      So in conclusion. Yes it is fraud. Yes it is deceit but gets people motivated one way or the other. I propose we use it for good for a change.
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        Oct 21 2011: intention is internal and private. action is important to us. fraud is fraud, whatever your intentions and reasons are.
      • Oct 21 2011: Placebos work. There is abundant evidence to that fact. Check out Ted Kaptchuk's work on the placebo.

        Placebos are incredibly important in differentiating signal from noise in clinical experiments. What makes them ethicla is informed consent.

        What you're proposing is fraud. It doesn't matter if the fraud is towards a "good change." The end does not justify the means.
  • Oct 22 2011: My question. How is this different from using hypnosis, or Ericksonian therapy, or advertising, or coaching, or giving a speech or anything that changes the way people relate to themselves, without actually raising their level of awareness of why they do what they do.

    People influence people all the time without questioning how ethical it may be.

    Also people all over the world suffer from various 'I can'ts' which are not true. They are in a trance telling themselves they can't do something. You're altering their trance. I would suggest the only thing with true integrity (and so ethical from my point of view) is to enable people to come out of the trance.
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    Oct 22 2011: A clear case of fraud ... BUT you could go as far as to say "Lots of people seem to think that there is an effect here, but it hasn't been supported by science, and there's no way to say for sure whether it works or not. On the other hand, we can guarantee that there are absolutely no side effects, ... unless you are suffering from diabetes".
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    Oct 22 2011: It's wrong to use the term "placebo" in this context. The placebo effect works at the interface of mind and matter and is the most important mystery of the human condition.
  • Oct 22 2011: Ethics is also related to being honest with one's beliefs since there is nothing like absolute ethics. if one truly believes using placebo will most likely help others where no personal gain involved other than mental happiness. then using placebo is as ethical action as any other.
  • Oct 21 2011: Efficacy by any other name...still works!
  • Oct 21 2011: A pill by itself - whether placebo or anything else - will never cure an illness, it's just a means to support a healing process.

    And a healing process is not about pills. It's about communication, developing an understanding for the situation, development of a solution, accompanying during the implementation of the solution and drinking a beer together after the problem is solved.

    If you feel the need to throw in a pill from time to time into the implementation part, because a specific person thinks that they can't do without one, then you can choose to do so to give a temporary positive effect.

    But the pills are not your product. The healing process should be. As maybe these community projects which you have in mind,
  • Oct 21 2011: Using a placebo can be a valid practice provided it's priced reasonably for what you're doing. If you have an ethical issue with using mental tricks to get your patients' bodies to heal themselves, then donate the profit margin of those placebos to a good charity.

    Telling people their bodies are capable of fixing certain issues without assistance doesn't usually work because people often doubt such things subconsciously, so the alternatives to using placebos are (1) sell them something expensive and dangerous or (2) let them continue making themselves sick. Allowing a person to harm him/herself can be construed as doing harm in some forums, after all.
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      Oct 22 2011: The problem with what you are suggesting is that there is evidence that the placebo effect is reduced if the placebo is less believable. I read that in medical trials they use placebos with mild side effects because patients with such placebos have an enhanced placebo effect. So if the actual treatment under test has side effects you must have the same level of placebo effect. Otherwise you can't be sure that it wasn't just an enhanced placebo effect.

      The same goes for economic placebos, the more a person pays the more likely it is to work (Unfortunately)
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    Oct 21 2011: I find myself leaning to the side of Carolyn Karnes, Michael Eskenazi and MA Boyd. I believe this question is not about whether placebo works or not. If it was, why not, for example, just pump them with antidepressants? (Your question was about what's ethical, not what's economical)

    Giving a pill is very condescending, because you are basically treating those people as being stupid. And from my experience with people, living in poverty, in most cases - however cynnical they would be and however self-perpetuating their mindset that's keeping them in poverty would be - they are not stupid. To do something like that could completely jeopardize your relations with those people and trust (as I understand it - you plan to keep communicating with them, as you will have a business there), either immediatelly or in the future, when they find that the lucky charm you sold them is just a peace of glass. And they WILL find out, and they will not sympathize with your sentiment.

    This is fundamentally dishonest and unfair to them, regardless of whether the pill would work for some or not. Because this is not about medicine - this is not pain relief, this is about empowerment, right?

    I'm afraid I cannot give you any specific advice in your sittuation - in our project for people in extreme poverty, we tried to show people the world outside their normal environment, to SEE with their own eyes, that it IS possible, but in your case this might be difficult.

    However, what I can say is, that it is not only 'unethical' (whatever that might mean) to sell them a success pill, but in the end, it will fail, as these people are not idiots, and you will not empower them by treating as such.
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    Oct 21 2011: ABSOLUTLEY!! Even better that poluting ones body with drugs! "What the mind can conceive and belive, it can achieve"!
  • Oct 21 2011: Belief CAN be good. Getting people to believe in themselves is the key, not that they believe in a ‘pill’, or that solutions to their problems can be medicated. (Obviously if the problem is medical, than a pill can work).
    This is a link for a BBC report about child sacrifice in Uganda.
    http://www.bbc.co.uk/news/world-africa-15267792
    Now I’m not saying that your placebo and child sacrifice are the same, but it is the same mentality; success (in whatever form) can come from outside myself. That it is someone (something) else’s gift, wither it’s a placebo, child sacrifice or a lucky rabbits paw.
    I would think that ‘deception’ is not the best way to engender self belief and confidence.
  • Oct 21 2011: just adding my logic: it's ethical as long as it's cheap enough to be accessible to everyone, but expensive enough to be credible; That means that you will not take material advantages from them.

    The placebo effect is officially recognized, from what I know (statistically at least), so I would approve if it would be up to me.

    To give a counter-argument to the idea that is better to teach them how business work... That would help too, but knowledge and self-confidence are two distinct things.. and business-mans around will correct me if I'm wrong, but YOU NEED BOOTH.

    Good luck!
  • Oct 21 2011: It really depends on a few things. You are asking whether it is ethical, so it depends on what ethical theory you subscribe to. The first question is whether or not you are taking profit from the placebos. If you are, then it turns to the question of what you do with this profit. If you are turning no profit from the placebos, then it is simply a matter of what value we place on your authority in this situation. If you are a doctor, I'd say it's unethical. Same goes if you are a scientist. But, as a 'Social Entrepreneur,' if you are turning no profit, there might be a gray area. It really depends on the ethical theory you subscribe to. Go from there. If you want, my opinion is that if you are selling these placebos, taking their money for it, then it's quite unethical. What is the purpose of selling the placebos is really a key issue in this question. If the whole point of your endeavor is to enact social change for the better, and help these people improve their lives, then this is a bad idea. You won't get a lot of good results. Even if you do, you know they will be ill-gotten. Or else you wouldn't be asking the question here. Likely, you already know the answer to your question, you just want a justification. I'd say take the hard route of the community projects you discussed. If the people are cynical, and you want to convince them they CAN do it, then show them they can and help them. It's ethical or unethical depending on how you view ethics. I simply think it is a bad idea.
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      Oct 22 2011: if you need to "con" people into buying your idea, it's still fraud.

      come clean.

      set expectations straight.

      that's how people will genuinely believe & hopefully start to follow you.

      good luck!
  • Oct 21 2011: as long as the placebo has no adverse physical effect, we can just consider it to be a form of psychological medicine i suppose.studies have shown that placebos do have positive effects on the users in some conditions...the line between placebo and scam though is a very fine one, that's where a doctor comes in.since a placebo would lose its psychological effect if the user came to know about it, someone else with the knowledge to take an informed decision for him viz. his doctor. should be the final judge.
  • Oct 21 2011: No and here is an example:

    To make it short: POWER BRACELET have been doing exactly that and now they have been banned from some countries and in the end they have admitted that it was a scam (http://gizmodo.com/5723577/powerbalance-admits-their-wristbands-are-a-scam)

    This is an illustration of what has happened to other people that had a similar idea (and an amazingly well build marketing plan...)
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    Oct 21 2011: It is important in this case to consider what is truly motivating you to do that. Knowing that placebo can truly help them, the ethical question now is "do you truly have those people's best in your mind or are you just trying to fool them for egoistic interest?"

    I think that as far as your goal isn't to take advantage of them, there's no more ethical question to be asked, because true help never cause ethical problem at all.
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    Oct 21 2011: Yes, great idea, let other people have our failed systems, maybe they find out how it supposed to work, so they can help us too!
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    Oct 21 2011: Very poor. people placebo pill=wrong yes tell them then! From an investment perspective it is Illegal!=Jail!
  • Oct 21 2011: Yes, it is wrong.

    To use an example from popular culture, a magic feather might work between an elephant and a mouse. Those fictional characters were friends, and the elephant did not resent that mouse for his actions. If you trust a friend, or if you sign a "release of liability" form with a reality show, you might allow a friend to lie to you. Readers of fiction trust the author to reveal a deeper truth using a lie, but this is explicitly stated at the front of the book. This kind of lie is imagination. If you don't have "suspension of disbelief" then you cannot tell a lie.

    If you want to educate people, you must do so honestly and without a placebo. Education is a search for the truth. If you educate them using a lie, then you are undermining the very effect you hope to achieve. Really great education teaches people that truth is sometimes impossible to know. (For proof that this is a measurable principle of the universe, see the Heisenberg Uncertainty Principle.) Education that enlightens people lets them understand the difference between the physical and the metaphysical. More concretely, an educated person must know the difference between opening a valve to release water, and reciting a verse to make it rain.

    Effective educators must gain the trust of their students. To truly achieve your goals, you must be willing to take on the full task of being patient with the people with whom you work. You must find methods to bring people up to your level of knowledge, giving them all the time and resources they need. Be brave: if you have taught the same subject 100 times and they still have not learned, teach them a 101st time. Also be prudent: you must know how much resources you have available to teach, and not pass those limits lest you injure yourself. Do not blame your students if they do not understand. Sometimes the cause of a failed education is also unknowable! By not blaming, you also protect the dignity and respect of them and yourself.
  • Oct 21 2011: Quickly on the moral front: yes deceit is wrong. In trials a person should know they they have a 50% chance of being in the placebo group. It's also wrong to allow people to falsely attribute their success to a pill, as this denies them chance to correctly learn from their experiences.

    On the placebo front though, I advise looking into recent studies where people given the placebo were *actually told* that they were being given a placebo. Amazingly, this has been shown to work just as well as when the person doesn't know they're taking a placebo. This alludes to the placebo effect being more to do with ritual than belief.
  • Oct 21 2011: I think you can use a "placebo" but instead of a pill, start with a quiz. Relatively easy but still makes them think. As long as they answer the question, call it correct. I've read information about children and IQ scores and when they were informed that they did very well on the IQ test (and the teacher was informed of this) the students actually performed better. Starting with confidence does A LOT to increase potential and performance.
  • Oct 21 2011: It is an interesting market ploy, but is far afield of using placebos in medical trials on humans. I look at it as being unethical, but surely not illegla if people understand the pills are reminders, not actual cures.
  • Oct 21 2011: Would a placebo really be needed/effective in this situation?
    Anyway, selling the idea that "people can do it" does not strike me as a "good" justification for a lie, even if it is a "white-lie".
    In my humble opinion, placebos are great only for controlled experiments in a scientific/statistical framework. Any other use, in principle, would be unethical.
  • Oct 21 2011: Why not teach them to find the "pill" within themselves. Don't have to lie to them, just help them remove the mask before their eyes, and if your community projects are geared towards this; especially in South Africa. Then you probably wont have any ethical problem selling faith!
  • Oct 21 2011: Sounds like network matketing to me... if your intention is really to help you will find a way to teach rather then fool them... if your intention is just to make money... easy come easy go
  • Oct 21 2011: The placebo effect is real. As long as you are following up with real actions to help the people in this community, I don't see the harm in giving them a placebo to put them in a better frame of mind about the help they are about to receive.
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    Oct 21 2011: For me, basically the argument is not with the object's put forth in the question, but with the relational circumstances of use. It is always ethically wrong to use placebo if other means were both transparent and equally effective.

    The placebo effect is one way to access the psychological abilities of an individual. If these faculties are intact, then it is probable that alternative means exist to access that same ability. It is not a yes no argument, because those were not all of the cards on the table.

    Another example of a problem which does not contain the solution in the question, something we all have to dredge through with American bi-partisan politics (and media), who rarely argue the real underlying issues.
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    Oct 21 2011: I agree with MA Boyd. The comment solidified the point I've made.
  • Oct 21 2011: In a business sense, what you are doing is acceptable, since you're filling a niche which, to the best of my knowledge, isn't filled very easily.

    On the subject of ethics, however, things start to get complicated.
    First of all, the placebo effect doesn't entirely rely on deceit. Studies have been done (I have read, see New Scientist) where even if a subject has been told that a pill is a placebo, and that it won't do anything, there were still beneficial effects. How reliable that study was, I'll leave to you more experienced guys, but it means something to me.
    Essentially, what you would no longer be providing a service; your customers could make up any bogus lie they wanted, as long as they believed it. That's where the whole ideal of 'my lucky red socks' comes from. Ethically, it would be wrong of you to take their money without returning them with a useful service; I guess you could sell thing such as talismans, foreign products, brightly coloured baubles, that sort of thing, for them to focus a placebo onto, or even sell coloured sugar pills if you want, without promising any kind of benefit, that at least would be a service, a trade of physical products.
  • Oct 21 2011: I worked for a company that offered "brain optimization" (data demonstrated no greater effect than placebo) for $2,000 and people ate it up! They never revealed the nature of actual data (claiming 85% reach one or more goals - with one goal of "relaxation" cleverly buried amid medical condition improvement goals). Apparently this is fully legal, but I find it ethically distasteful, esp when "convincing" the elderly. Does our assessment of the ethics of placebo change depending upon the cost involved?
  • Oct 21 2011: why make it a placebo? why not look into something that actually has an effect, and can actually change someones situation into a much more prosperous one? why not look into orgonite?

    if you want to gift the poor people of the world, why do it with a placebo? why not try something that actually works? make orgonite, give it to people, watch it change their lives.

    ORGONITE - why try to replace it with a placebo? :) why make a prosperous pill when you can make a prosperous pyramid? :) youtube orgonite, orgonites effect on the human aura, do an ebay search.. google orgonite, orgone, or orgone crystals :) im sure youll come across something you like, that works much better than a placebo pill.
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    Oct 21 2011: As part of a test where a placebo is used to eliminate the effect of researcher attention, then yes it's ethical provided participants know that they may get a placebo.

    As a focal point where a patient would recover without treatment, but believes strongly that they need treatment, it is justifiable but this is a grey area in terms of ethics. Afterwards, if the practitioner tells the patient, then this is likely to destroy trust. If the practitioner doesn't tell the patient then this reinforces the patient's belief that treatment was needed, which may cause problems at a later date.

    In circumstances where the practitioner doesn't want to give treatment, maybe because it has adverse side effects, or none is available, or it is too expensive, then it is not ethical. The practitioner is relying on manipulation of the patient's beliefs, without the consent of the patient.

    Looking at the level of incorrect diagnosis and inappropriate treatment in many medical organisations today, I would be strongly opposed tocondoning the use of placebos because it encourages slipshod diagnosis and giving inadequate treatment in order to cut costs.
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    Oct 21 2011: I think a disclaimer would be needed to say something like "it works for some and it may work for you" It would be catch 22 because you need your pill takers to believe that they have taken a cure for "finances" and to do that you would have to market it as if it does work and the truth is it doesnt work all the time for all the people so would be false advertising. You would have to market it saying it may work, and for those that are susceptable enough to take a placebo knowingly to be a placebo and it still work would get the benefits. You are aiming at a small minority of the public so I would suggest a better product aimed at a bigger demographic. As a real placebo you will affect about 20% of people and as an honest "snake oil" it would be much less so either way you do not have a large demographic to sell the product to.

    It would be unethical to lie about it's claims in order to trick people into thinking they were buying the real deal which is what you need for the placebo to work.
  • Oct 21 2011: Not sure if this is a conceptual/abstract question or a concrete realist idea: the business plan is a pill or an actual pill will help you with your business plan. I believe It's only unethical if you know it won't work. Placebos work sometimes and medicinal pills work sometimes so which is unethical? It's easier to test medicine over placebo. Just make sure your placebo is sound. You have a plan and a way to fulfill the plan and you can't bail on the people you offer the placebo to - that would be unethical. No plan ever guarantees success but if you don't make the plan and never put it into action you do know that you will never find out if it would have worked.
  • Oct 21 2011: I suggest you read the bestselling book, "The Three Laws of Performance," which addresses the mindset of cynicism you are uncovering - and how to work with people to achieve the results you want...empowering and inspiring...
  • Oct 21 2011: I would be concerned about the foundation you are laying. Having someone 'take a pill' to change their viewpoint might work for a bit. However, the brain pathway that is developed is that 1. the pill and 2. the person who gave the pill really are responsible for the success.

    Placebos use our imagination to modify our reality. There are other, more beneficial ways, to access the imagination. The culture you are working in probably has a place for stories. What would happen if you shared stories of villages that were changed to the better by new businesses and learning? What if you created small group discussions of 'what if', being careful to direct the conversation to the positive, and allowed the people to begin describing a new reality to themselves?
  • Oct 21 2011: I don't see any problem with the idea of placebos as an idea. It's not like you are giving anyone drugs that might interact with them badly. People often have huge mental restraints on their own mindspace and abilities. A great percentage of the time, when it is proven to someone just how capable and able they are to perform or grow in any fashion. it is a huge boost to their self confidence and leads to a lifetime of success that may not have happened otherwise. I would think I'm a huge user of idea placebos myself, often using the method to encourage youngsters and others around me to see themselves as I do and to facilitate their success. I think it is wonderful what you are doing and I wish you great success!