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We provide a new perspective with which to understand what for a half century has been known as the "placebo effect." We argue that, as currently used, the concept includes much that has nothing to do with placebos, confusing the most interesting and important aspects of the phenomenon. We propose a new way to understand those aspects of medical care, plus a broad range of additional human experiences, by focusing on the idea of "meaning," to which people, when they are sick, often respond. We review several of the many areas in medicine in which meaning affects illness or healing and introduce the idea of the "meaning response." We suggest that use of this formulation, rather than the fixation on inert placebos, will probably lead to far greater insight into how treatment works and perhaps to real improvements in human well-being.

NEWS AND VIEWS FROM THE EDITORS OF THE NATIONAL REVIEW OF MEDICINE

Perry Cross, a ventilator-dependent quadriplegic, traveled to India to receive daily injections of stem cells. He claims that, owing to the stem cell treatment, he is now able to breathe on his own for the first time since a rugby injury made him a quadriplegic 14 years ago. The breakthrough is likely to fire up the stem cell debate once again

Walter Fiers found a protein segment on the influenza virus that could lead to a universal flu vaccine, which would end seasonal shots and provide pandemic protection

A vaccine that can eliminate seasonal flu shots and provide protection against pandemics? Walter Fiers discovered that targeting a particular protein segment on the influenza virus might just do the trick

For Claudius Conrad, a 30-year-old surgeon who has played the piano seriously since he was 5, music and medicine are entwined — from the academic realm down to the level of the fine-fingered dexterity required at the piano bench and the operating table.

This spring, the President's Council on Bioethics released a 555-page report, titled Human Dignity and Bioethics. The Council, created in 2001 by George W. Bush, is a panel of scholars charged with advising the president and exploring policy issues related to the ethics of biomedical innovation, including drugs that would enhance cognition, genetic manipulation of animals or humans, therapies that could extend the lifespan, and embryonic stem cells and so-called "therapeutic cloning" that could furnish replacements for diseased tissue and organs. Advances like these, if translated into freely undertaken treatments, could make millions of people better off and no one worse off. So what's not to like? The advances do not raise the traditional concerns of bioethics, which focuses on potential harm and coercion of patients or research subjects. What, then, are the ethical concerns that call for a presidential council?

The Mind-Body Connection

Billionaires bring a new twist to alternative medicine