Waring Duff
Biomedical Ethics Unit, Faculty of Medicine, McGill University, Montreal, Quebec.
Theor Med Bioeth. 2003;24(1):5-17. doi: 10.1023/a:1022988413047.
Grunbaum claims that the remedial failure of a treatment's characteristic factors is the generic, objective property of a placebo. He stipulates that a treatment is placebic if this remedial failure exacerbates the target disorder. This stipulation can subsume as placebic effects that might be solely pharmacological, e.g., paradoxical reactions to certain psychiatric drugs. If that exacerbation can be explained pharmacologically, then we might question whether Grunbaum's definitional scheme captures the core identity of what we usually intend by the placebo concept. I propose that this core identity is best captured by a symbolic meaning hypothesis in which psychological factors exert the determinative influence.
格鲁恩鲍姆声称，一种治疗方法的特征因素的治疗失败是安慰剂的一般客观属性。他规定，如果这种治疗失败加剧了目标疾病，那么这种治疗就是安慰剂性的。这一规定可以将可能仅仅是药理学上的效应，例如对某些精神药物的矛盾反应，归为安慰剂效应。如果这种加剧可以从药理学角度得到解释，那么我们可能会质疑格鲁恩鲍姆的定义方案是否抓住了我们通常用安慰剂概念所指的核心本质。我认为，这种核心本质最好由一种象征意义假说捕捉，在该假说中，心理因素发挥决定性影响。
