Abstract
This dissertation defends the use of placebos in clinical treatment and reinterprets African Traditional Medicine (ATM) as (at least in part) a systematic harnessing of the placebo effect through the mechanisms of the placebo: expectancy and conditioning.
Despite their long history of use and cultural significance, both Complementary and Alternative Medicine (CAM) and ATM have long been marginalised by Western biomedicine, often dismissed as unscientific or ineffective. Such a dismissal reflects not only scientific narrowness but also a deeper epistemic injustice, more specifically willful hermeneutical ignorance - the unjust refusal of dominant knowledge systems to engage with alternative frameworks of healing. By failing to recognise the therapeutic benefits of placebos and the cultural value of ATM, healthcare systems perpetuate injustice, which silences patients’ voices and excludes culturally embedded practices from legitimate medical discourse.
Central to this defence is the placebo effect, with its measurable improvements in health arising from patient expectations, conditioning, contextual cues and meaning response to healing. These mechanisms play a significant role in ATM, where rituals and symbols foster healing that is both physical and psychological.
The ethical foundation for my argument is drawn from principlism as developed by Beauchamp and Childress (1979). I argue that placebo use and ATM can be justified through respect for autonomy (ensuring informed consent, including open-label placebos), beneficence (promoting wellbeing even through non-biomedical mechanisms), nonmaleficence (avoiding unnecessary pharmaceutical harm), and justice (ensuring equitable access to all types of care). Taken together, my arguments establish that placebos and ATM are not simply pseudoscientific practices but ethically defensible, medically valuable, and culturally indispensable components of healthcare. I further suggest that their integration into public health systems would bring us closer to a just and inclusive approach to healing.