Books reviews, current events, and other musings

Daniel Moerman’s Meaning, Medicine, and the ‘Placebo Effect’ is the first medical anthropology book that I’ve come across. He describes a wide range of studies that shed insight into how people respond to placebos. He demolishes the theory that certain psychological personality types are susceptible to placebos. Instead, he argues that the patient’s meaning response – how their understanding of the medical procedure fits into their world view – has a significant impact upon their health.

For example, most Americans view injections as more potent than pills, and as a result shots tends to generate more of a placebo effect than pills do. However, among European patients no such difference exists. In another experiment, the subjects were divided into four groups, each receiving a different painkiller: placebos, placebos labeled with a heavy advertised brand name, aspirin, and aspirin with that brand name. Aspirin was more effective than the placebo (holding branded / not branded status constant), while the branded drugs were more effective than the unbranded drugs (holding placebo / aspirin status constant). Finally, a study examined the longevity of Chinese-Americans and Caucasian Americans with various medical conditions. According to the Chinese tradition, people born in certain years are more likely to suffer various medical ailments. The average Chinese longevity for some afflictions varied by up to five years, according to the birth year, while Caucasians didn’t have any correlation.

Moerman analyzes other manifestations of placebos. Studies of various schools of psychotherapy have shown that they’re all equally effective, as is simply talking to an empathetic individual who doesn’t have any psychological training. For certain operations, placebo surgery can be just as effective as real surgery. The physician’s belief regarding a procedure’s effectiveness has a major impact on how the patient responds. One study demonstrated that a particular drug blocks the placebo effect from occurring.

His emphasis on the meaning effect seems, at times, to be belaboring the obvious. Everyone acknowledges the mind-body connection in terms of ones health, and the idea that each person perceives the world differently is a standard meme in our intellectual culture. Since it makes perfect sense to put those ideas together when considering placebos, I didn’t need that much convincing.

The book was completely accessible to someone, like me, who knows very little about medicine. The recitation of experimental results became a little dry at times, but in a fairly short book that wasn’t a big deal. I finished the book wondering how doctors and patients could apply its insights to improve the healing process. It’s worth reading if you’re curious to learn more about the interaction between mind and body.

posted by Julian at 8:05 PM