The Meaning Response, "Placebo," and Methods

Perspect Biol Med. 2018;61(3):361-378. doi: 10.1353/pbm.2018.0049.


In 2002, Dan Moerman outlined three candidate explanations for the "placebo response": the "conditioned stimulus-response," Irving Kirsch's "response-expectancy" explanation, and the "meaning response." The meaning response, Moerman argued, was the only one of the three candidate explanations that could cover all the data, gained from decades of RCTs and centuries of historical record. Moerman went so far as to propose replacing the term "placebo effect/response" with the term "meaning response," because people are not responding to placebos, since there is nothing to respond to; people are responding to meanings. There is evidence of medically significant meaning responses where there is no evidence for conditioning. Similarly, there is evidence for such responses where those subject to them lack the knowledge-epistemic capital-required to form the beliefs which might constitute an expectation. Something else, neither conditioning nor propositional attitudes, explained placebo responses, and Moerman proposed the meaning response. While the authors consider the meaning response to avoid the pitfalls of conditioning and response-expectancy, it has been subject to criticism. The criticisms have focused on what is seen as the explanation falling foul of the naturalistic demand and not fitting with prevalent predilections in the philosophy of mind and cognitive science. This article seeks to allay these worries and proposes the inclusion of ethnomethodological fieldwork in future research.

MeSH terms

  • Anticipation, Psychological
  • Conditioning, Classical
  • Humans
  • Knowledge
  • Models, Psychological
  • Placebo Effect*
  • Randomized Controlled Trials as Topic
  • Research Design