Placebo Surgery for Chest Pain 

In the late 1950’s, a common treatment for a condition called Angina pectoris was a surgery identified as bilateral ligation of the internal mammary arteries.  Angina pectoris is a condition that causes chest pain resulting from reduced blood flow to the heart. Physicians had the belief that tying off the mammary arteries would reduce any complications or symptoms. This idea led to the question of whether the surgery was successful or if the patients were feeling better because they believed the treatment would help them. In 1959 in Seattle, Washington, Dr. Leonard Cobb and his coworkers directed a double-blind controlled experiment to decide whether the surgery was successful. Even though the patients were informed that the surgery had not been reliable or effective, they did not know that they were going to be a part of this controlled experiment where they would not receive the actual procedure. This experiment was known as placebo surgery, also known as sham surgery. Placebo surgery is defined as a form of medical treatment that is intended to deceive the patient who believes he/she received proper treatment.

Seventeen patients who suffered from severe chest pain were selected to be a part of this study. Before the surgery happened, the patient’s physical condition were monitored and measured.  In Cobb’s experiment, eight out of the seventeen patients received the actual artery ligation surgery, while nine patients underwent the placebo surgery. The placebo surgery consisted of a small incision and a local anesthetic. The purpose of this study was to determine whether progress was caused by the surgery or the placebo effect, which transpires when patients improve because they think they received proper medical treatment.  

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The patients were evaluated after the surgery throughout three to fifteen months. Out of the eight patients who received the actual surgery, five disclosed that they felt improvement in their symptoms. This improvement was also surprisingly reported by five out of the nine patients who received the placebo surgery. When examined by physicians, only two patients showed signs of physical improvement, who both went through the placebo surgery. The results from the experiment showed that the placebo surgery was just as effective as the actual procedure.  

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Even though this experiment exhibited key details about the effectiveness of placebo surgery, it raises significant ethical concerns. The patients who took part in the study were not truly informed that they were going to receive a ‘sham’ surgery, which means they did not give informed consent. Furthermore, placebo surgery can create unnecessary risks and complications for patients. The long-term effects of this for 9 patients were infections and trauma. During Cobb’s trial, there were no strict consent laws or review boards. But today, placebo surgeries are controversial and unethical because of the deception it causes. Patients must be informed about what surgery involves and their plan of treatment. Placebo surgeries still occur in clinical trials to test treatments for Parkinson’s Disease and musculoskeletal pain.  

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Citations:

Benson, H. et al. (1979). Angina Pectoris and the Placebo Effect. New England Journal of Medicine, 300(25), 1424–1429. doi:10.1056/NEJM197906213002508. Accessed 5 Apr. 2026. 

Hostiuc, S. et al. (2016). Placebo in Surgical Research: A Case-Based Ethical Analysis and  Practical Consequences. BioMed Research International, 2016, 1–7.  https://doi.org/10.1155/2016/2627181https://doi.org/10.1155/2016/2627181 

Accessed 5 Apr. 2026. 

Wolf, Brian R, Joseph A Buckwalter. “Randomized surgical trials and "sham" surgery:  relevance to modern Orthopaedics and minimally invasive surgery.” The Iowa  orthopaedic journal vol. 26 (2006): 107  https://pmc.ncbi.nlm.nih.gov/articles/PMC1888585/. Accessed 5 Apr. 2026.