This article is built upon a questionable definition of the placebo effect. Debatably, it’s a straw man argument that sidesteps the complexities of placebo response by using an oversimplification that is easier to dismiss.
The placebo effect varies by treatment and illness. Placebo isn’t fixing broken legs or making cancer disappear. Placebo effects are strongest where measures involve perception and are related to more complex mental processes.
Pain is a common example. Pain is a sensation, but sharp pain is associated with additional fear and panic response. Placebo addresses some of the fear and panic response, thereby addressing part of the pain. I agree that some of the studies showing placebo performing as well as fentanyl and morphine are likely flawed. We have a lot of studies showing dose-response curves for pain management using OTC analgesics, so it’s laughable to see a study showing a dose-response curve that is basically flat or inverted (placebo == 0mg dose).
The placebo effect gets much more complicated in the context of mental health. Anti-depressant studies are the classic example, with placebo often performing close to (but not as well) as powerful SSRIs. This has created internet backlash that “SSRIs are almost placebo” but the truth is that placebo groups improve dramatically during the study, too. There is something about the hope of receiving treatment, the way patients are told that they’re possibly receiving a treatment, the act of self-measuring and reporting mental health scores, and the interactions with clinicians that causes many (though not all) people to turn a corner and start improving. It’s almost as if they’ve received a signal that the end of their suffering is near so they start reactivating themselves, thereby improving the depression. The SSRI groups usually perform better by a statistically significant amount, but the challenge is that the placebo group improves so much that there is little numeric resolution left in the depression inventory to see much signal!
It’s a strange phenomenon, but I don’t think this article is a good overview of the effect let alone a rebuttal to it.