BIAS IN CONNECTION with a given procedure on the part of the physician, or the patient, is a complex and often misleading factor in the treatment of disease. Bias has many components, but it is nevertheless possible to separate and examine one of its powerful determinants, the placebo effect.1-3 Specific attention could be directed to various areas in medicine; I have chosen to look into the matter as it concerns surgery. Surgery offers admirable possibilities for such study.
Wolf2 defines a placebo effect as "... any effect attributable to a pill, potion, or procedure, but not to its pharmacodynamic or specific properties." There is the possibility, then, that the surgeon or a surgical procedure can exert a placebo effect. In short, the problem is to investigate (1) the existence, nature, and extent of the placebo effect in surgery, and (2) the possibility that the placebo effect of the