Henry Knowles Beecher was a pioneering American anesthesiologist, placebo effect researcher, and medical ethics specialist. Due to his somewhat controversial character—breaking barriers and revolutionizing everything around him—we're certain he would have been part of the Sedalux team.

Raised in rural Kansas during World War I, he changed his German surname to the Anglophone Beecher in the 1920s and traveled east to earn his medical degree at Harvard. During World War II, he conducted influential research on pain, bringing the issue of placebos to the forefront of discussions about how to properly design clinical trials.

He took notes on his observations during the combat at the beaches of Anzio and the horrors of Monte Cassino, where he continued describing pain and resuscitation while fulfilling his duties in the war—experiences that would inspire his future work. This later allowed him to propose the hypothesis that pain had two aspects: the actual tissue injury and the personal meaning of that pain for the individual. He was ahead of his time in understanding the difference between nociception and pain (or painful experience), as well as the complexities of our psyche in pain processing.

In his study on the impact of pain in soldiers, he observed that wounded soldiers requested pain medication less frequently than civilians with similar injuries. His explanation was that the consequence of the painful experience was different for soldiers than for civilians. For a soldier, a serious wound could mean being relieved from combat, whereas for a civilian, a wound meant personal inconvenience, loss of time, and money (Beecher, 1945).

Between the end of World War II and the beginning of the Cold War, Beecher was funded by the Office of the Army Surgeon General with $150,000 to investigate “The development and application of drugs that would assist in the establishment of psychological control.” He became involved in experiments with lysergic acid (LSD), secobarbital, amphetamines, and meperidine. He was heavily criticized, despite the fact that his work on the effects of LSD was consistent with the research line he had started during the war. We should also consider that until 1960, LSD was a legal drug approved for use, and Beecher’s work was published about a decade earlier. Furthermore, the drug was not yet considered a hallucinogen, but rather had “psychotomimetic” effects.

He was accused of double standards for conducting LSD research with military funding, but his writings reflect his genuine concern for understanding higher brain functions and the effects of drugs (which, at the time, had not yet been extensively developed or linked to specific pathologies and behaviors). As a person of integrity and transparency, he acknowledged the mistakes in the studies he participated in and consistently sought to ensure others would not repeat them.

In addition to raising concerns about clinical safety in anesthetic practice, in 1968 he led a Harvard working group to examine the definition of “brain death”, which established influential and controversial standards that allowed doctors to disconnect patients from life support. This was the first consensus on brain death criteria: the so-called “Harvard Criteria.”

But what made him truly remembered was his article “Ethics and Clinical Research” published in the New England Journal of Medicine (NEJM) in 1966, in which he sought to highlight a weakness in research ethics. He exposed 22 studies that violated human rights, sparking and embedding in the scientific community a necessary debate about the scope and limits of medical ethics—and how to assess the harm caused by exposing human beings to “experiments.” His work was fundamental to the implementation of federal regulations on human experimentation and informed consent.

Beecher inspired the current landscape of health research. His life was marked by profound contradictions and tensions between ethical and unethical, legitimate and illegitimate, legal and illegal, right and wrong, doubt and certainty. Nevertheless, he was an anesthesiologist ahead of his time, envisioning that the most tangible and practical expression of ethics is “integrity” in research.

When the Allies were fighting to liberate Europe from Nazi control during World War II, the demand for morphine in field hospitals was extremely high, and it became scarce when battles resulted in heavy casualties. Sometimes, surgeries even had to be performed without anesthesia. On one such occasion, Henry K. Beecher, an American anesthesiologist stationed on the southern front of Italy, was preparing to operate without morphine on a soldier with very serious injuries. Then something incredible happened: one of the nurses injected the soldier with a saline solution and, to Beecher’s surprise, the soldier immediately calmed down. Not only did he barely feel any pain during the surgery, but he also experienced no cardiovascular effects. Apparently, “the saltwater acted as a powerful anesthetic.”

Beecher began using this new “trick” whenever he ran out of morphine — and it worked. After the war, back in the United States, Beecher dedicated himself to investigating the placebo effect more thoroughly: the mind’s striking ability to produce real changes in the body simply by believing in the treatment being administered.

Beecher reviewed 15 placebo-controlled trials of treatments for pain and other ailments. The studies involved 1,082 participants and found that, overall, 35% of patients’ symptoms were relieved by placebo alone. As a result of this work, in 1955 he published his famous article “The Powerful Placebo”, which would go on to become a classic, highlighting — among other things — the importance of placebo in medical research.

But Beecher wasn’t the first to use the term placebo. The first was T. C. Graves in an article in The Lancet in 1920. What brought Beecher recognition was his article “Ethics and Clinical Research”, in which he sought to draw attention to a weakness in research ethics, issuing explosive critiques to the medical community of his time about the need for clinical trials to be placebo-controlled and conducted using the double-blind method — now the standard protocol when testing the efficacy of a drug or vaccine.

But this wasn’t the only contribution of this ambitious and controversial anesthesiologist. If you want to know more, we’ll tell you HERE. 😉

Since time immemorial man has tried to avoid pain and to manage it in some way in order to alleviate or suppress it.

Without wishing to make a historical review of the many written references on pain, since ancient times there has been an evident concern to try to control it.

An interesting concept of modern medicine is how physical pain is blurred with psychic pain, often becoming confused. The boundary between the one and the other has always been very tenuous and easily crossed, making it difficult to distinguish well between pain and suffering, so it is easier to consider it as a whole; Aristotle already described the two “with center in the heart”.

With this brief “historical brushstroke” we can get an idea of how interventions were in the past and remember how pain, consciousness and anesthesia have always gone hand in hand.

In everyday language “consciousness” and “conscience” are often used interchangeably, but there is a subtle difference, especially in medical, philosophical or psychological contexts.

• Consciousness (with an s):
  • Refers to the state of being conscious, i.e., awake, alert, and in touch with the environment.
  • It is the term most commonly used in medicine and neuroscience.
  • Example: The patient regained consciousness after the operation.

• Consciousness (with c):
  • Refers more to the ability to discern between right and wrong, or to have reflective awareness of one's actions and the reality around us.
  • It is more common in philosophy, ethics and moral psychology.
  • Example: He has a clear conscience because he knows he acted correctly.

Consciousness is a neurological function that relates to the alertness of our brain, which can be altered by a variety of factors, including diseases (e.g. meningitis, epilepsy, tumors), injuries (e.g. head trauma, brain hemorrhage), substances (e.g. drugs, alcohol), psychological or sensory experiences (e.g. hypnosis, meditation) and ANESTHESIA.

These alterations may manifest as a decrease in alertness (drowsiness, lethargy), changes in perception or thinking (confusion, stupor) or even complete loss of consciousness (coma).

UNCONSCIOUSNESS = LOSS OF CONSCIOUSNESS

But then why do we say “loss of consciousness” if the correct thing would be “loss of consciousness”?

The main reason is historical-linguistic and popular usage:

• In common Spanish usage, “conciencia” has been the most widespread form for a long time, even when referring to the state of alertness (what in medicine is called conscience).
• That is why expressions such as “perder la conciencia”, “recobrar la conciencia”, etc., have become so commonplace that even in medical contexts some professionals continue to use them by mistake, out of habit or to make themselves understood by the general public.

So is it totally incorrect to say “loss of consciousness”?

• Technically, yes: in medicine and neuroscience, it is more accurate to say “loss of consciousness”, since it refers to an observable brain function (level of alertness, response to stimuli).
• Linguistically, not quite: the Royal Spanish Academy (RAE) accepts both forms and explains that “conciencia” can be used with the meaning of “conscience” in some contexts, although it recommends differentiating them when there is a risk of confusion.

So, as a practical summary, saying “loss of consciousness” is not a serious error, but in clinical or scientific contexts “loss of consciousness” is preferred to avoid ambiguity, since “conscience” can also refer to the moral or introspective.