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A placebo is a sham medical intervention intended to lead the recipient to believe that the intervention may improve his/her condition. In one common placebo treatment, a patient is given an inert "sugar pill" and told that the pill may improve his/her condition. The fact that the pill is inert is withheld from the patient. The intervention may cause the patient to believe that the treatment will change his/her condition; this belief sometimes causes the patient's condition to change, a phenomenon known as the placebo effect.
Placebos are widely used in medicine, and the placebo effect is a pervasive phenomenon; in fact, it is part of the response to any active medication. However, the deceptive nature of the placebo creates tension between the Hippocratic Oath and the honesty of the doctor-patient relationship. The placebo effect points to the importance of perception and the brain's role in physical health.
In 1955 Henry K. Beecher published the "The Powerful Placebo", and placebos have since been considered to have clinically important effects. This view was notably challenged in 2001 when a systematic review of clinical trials concluded that there was no evidence of clinically important effects except perhaps in the treatment of pain and continuous subjective outcomes. The article received a flurry of criticism, but the authors later published a Cochrane review with similar conclusions. Most studies have attributed the difference from baseline till the end of the trial to a placebo effect, but the reviewers examined studies which had both placebo and untreated groups in order to distinguish the placebo effect from the natural progression of the disease.