Placebos are inactive substances used to compare results with active substances. And in sham treatments, the doctor goes through the motions without actually performing the treatment. A placebo is often used in a drug trial to help show whether the drug being studied is more effective than an inactive "sugar pill. The results of each group are compared. In a sham treatment, some people get the real treatment while others get the sham treatment. Then the results are compared. When a person who is taking the inactive substance or who has had a sham treatment reports that symptoms have improved, this improvement is called the placebo effect.
It is probably a result of the brain releasing "feel-good" hormones such as endorphins in response to treatment. Active drugs and therapies can also have a placebo effect. Blinding is facilitated by the use of placebo treatments or sham procedures. For example, in a study designed to evaluate the efficacy of arthroscopic surgery in treating painful osteoarthritis of the knee, subjects in the sham surgery group had a small incision placed on the knee under sedation, but arthroscopic surgery was not actually performed.
Instead, the surgeons simulated the procedure by asking to be given the usual instruments and manipulating the knee of the subject as if the real procedure were being performed. Sham surgery is more problematic than use of a placebo, because it has the potential for causing harm and because the patient is being actively deceived.
For a detailed discussion on the ethics of sham surgeries, see Miller FG and Kaptchuk TJ: Sham procedures and the ethics of clinical trials. J R Soc Med. Placebo: a pharmacologically inert inactive substance that is otherwise indistinguishable from the active treatment. When a certain "standard of care" is routine for a given condition, it is probably not ethical to assign subjects to a placebo group. Sham: similar to a placebo, a sham is a fake procedure designed to resemble a real procedure that is being tested for efficacy.
Masking is not always necessary, nor is it always possible. If the primary outcome of interest is definitive and objective, such as death, then masking isn't necessary. In addition, if the treatment is an elaborate surgical procedure, the ethics of doing a sham procedure would be questionable. The Placebo Effect The use of placebos and sham procedures facilitates masking and thereby prevents bias in assessment of subjective outcomes, such as pain relief.

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Some Popular Surgeries Are Just Placebos, Here’s Why They Still ExistBut they may be helpful even if you know they're fake.
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