We provide a new perspective with which to understand what for a half century has been known as the "placebo effect." We argue that, as currently used, the concept includes much that has nothing to do with placebos, confusing the most interesting and important aspects of the phenomenon. We propose a new way to understand those aspects of medical care, plus a broad range of additional human experiences, by focusing on the idea of "meaning," to which people, when they are sick, often respond. We review several of the many areas in medicine in which meaning affects illness or healing and introduce the idea of the "meaning response." We suggest that use of this formulation, rather than the fixation on inert placebos, will probably lead to far greater insight into how treatment works and perhaps to real improvements in human well-being.

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Daniel Moerman presents an innovative and enlightening discussion of human reaction to the meaning of medical treatment. Traditionally, the effectiveness of medical treatments is attributed to specific elements, such as drugs or surgical procedures, but many things happen in medicine which simply cannot be accounted for in this way. The same drug can work differently when presented in different colours; drugs with widely advertised names can work better than the same drug without the name; inert drugs (placebos, dummies) often have dramatic effects on people (the 'placebo effect'); and effects can vary hugely among different European countries where the 'same' medical condition is understood differently, or has different meanings. This is true for surgery as well as for internal medicine. This lively 2002 book reviews and analyses these matters in lucid, straightforward prose, guiding the reader through a very complex body of literature, leaving nothing unexplained but avoiding any over-simplification.