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Old 31 January 2013, 10:55 PM
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Richard W Richard W is offline
Join Date: 19 February 2000
Location: High Wycombe, UK
Posts: 26,439

If there wasn't a placebo effect, it wouldn't need to be controlled for - people would control against groups that weren't receiving treatment at all.

The problem is one of definition, here, I think, and the level that you're looking at. You're taking the "placebo effect" and breaking it down into components, and then saying that because you can do that, the "placebo effect" doesn't exist.

There are times when a reductionist approach does remove the need for an overarching concept - "God", for one, is made up of a lot of unrelated and disparate ideas, some of which are valid and some aren't, and personally I think that the concepts are sufficiently different that the term itself is meaningless and actively confusing. But at other times, it's quite valid to group phenomena together and give them a name, even if you can break these down into more detailed entities. An "atom", say. A "carbon atom" is a useful concept even if, in reality, it's a collection of other waves and particles and ideas, and an "ideal" carbon atom doesn't exist.

I'd say that even if the "placebo effect" is a combination of the other things you've mentioned, it's still an effect. It still needs to be controlled for in a medical situation, and rather than writing out all of those other possible effects in full, usually it's useful to treat it as a single effect so that you can evaluate the effectiveness of the drug you're looking at.

That's no reason not to dive into it further, just as the periodic table is no reason not to look into atomic structure. But equally, the existence of electrons, and covalent bonding, and radioactive isotopes, doesn't mean that there's no such thing as a "carbon atom".
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