The Power of Placebos: Should Doctors Become Shamans?

Jeremy Howick's The Power of Placebos (2023) invites readers to reconsider what counts as "real" effects in clinical medicine. The book resists the temptation to delve into the causal interpretation problem and instead asks an interesting question: how should clinicians act, given what's known about mind-body connections and increasing evidence of the importance of patients' beliefs and expectations? Howick argues that rituals, empathy, and meaning can exert biological force and therefore deserve to be studied, taught, and practiced with the same seriousness as drugs and devices. The pragmatic challenge is to design and test multicomponent interventions that harness placebo benefits while minimizing nocebo harm. If realized, the task for modern medicine would be to find new ways of ethically and transparently integrating effective care packages into practice. Doing so could not only help restore trust in medicine but also reclaim space that is too often ceded to unregulated actors and online influencers. While paradoxes and ethical quandaries remain, Howick's proposal merits serious consideration. It may help clinicians fulfill a deeper role in society as empathetic guides who foster healing by helping patients make meaning amid existential uncertainty.