I haven't mentioned it very often, but there are many ethical issues which people routinely raise about placebos. This has been a perennial problem in medicine, I think. The primary problem is that, historically at any rate, when doctors really didn't know what to do for a patient, or simply didn't have any treatment which they thought might be effective, they often gave people inert drugs: bread pills, sugar pills, whatever. In a famous passage from a letter to a physician in 1807, Thomas Jefferson wrote: “One of the most successful physicians I have ever known, has assured me, that he used more bread pills, drops of colored water, & powders of hickory ashes, than of all other medicines put together. It was certainly a pious fraud.” Jefferson is forgiving, but he does credit this action to be a “fraud,” even if a “pious” one. That the use of placebos seems somehow “fraudulent” is a serious problem for medicine.

The case of the Kwakiutl shaman

One of the great cases, which raises many important issues, can be found in anthropologist Claude Levi-Strauss' famous paper “The Sorcerer and his Magic” (Levi-Strauss 1967b). In it, Levi-Strauss analyzes the case of Quesalid, a Kwakiutl Indian from Vancouver Island in British Columbia, a case originally reported a generation earlier by Franz Boas (Boas 1930). Quesalid had reason to believe that the shamans were cheats and frauds, shamelessly exploiting their patients with trickery.