The observable examined

Placebos in the news

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The topic of Placebos – known to most people as sugar pills – has been in the news, lately.  At hand is the issue of whether placebos are an effective treatment option for some illnesses. Michael Specter’s article –the Power of Nothing – in the December 12 issue of New Yorker, provides a very nice overview of the status of placebos in the medical community. To most practitioners of medicine, placebos are pretty useless. In fact, this bias is obvious in the National Institute of Health’s definition: “placebo is an inactive pill, liquid, or powder that has no treatment value.”  Ted Kaptchuk, one of the key figures in the New Yorker article, would beg to differ and is taking on the establishment, with Harvard and guess what, the NIH’s blessing! Based on his many years of “healing patients” and their experiences, he is of the opinion that “….an important component of medicine….involves suggestion, ritual, and belief.”

In other parts of the article he makes a case for realizing the importance of the doctor-patient relationship and its impact on healing. For example, he agrees that acupuncture is not really an effective clinical intervention, but his patients found relief – “It’s about the man.” Sadly, in my opinion, this aspect of medicine – the doctor-patient nexus – is a lost art. Western medicine, as practiced today, is totally recipe driven with little to no human touch (owing in no small part to the specter of potential lawsuits, I am sure).

Researchers have also documented the fact that patient expectations seem to affect the placebo response. If you take Valium without knowing you took it, you do not obtain relief from anxiety. Other clever studies have shown that there is a biological component to the placebo response. It is true that the placebo response seems to be most effective is relieving pain. (This should not be all that surprising given that other studies have shown that distractions can diminish pain, if you assume placebo is such a distraction). However, more recently there is evidence that placebos are effective in weight loss programs, and in treating depression, migraines and Parkinson’s. For specifics you can read the Wall Street Journal article: Why Placebos Work Wonders. You can also go to ScienceFriday.com, which features an interview with Ted Kaptchuk and includes links to the mentioned articles.

The establishment’s beef with placebos seems to center around the issue of whether it is ethical to prescribe placebos to patients (it is deceptive if you don’t tell the patient that they are receiving “sham” treatments) and the fact that placebos cannot halt the progress of a disease (although some people use them interchangeably, illness has a distinct definition).  I suppose part of the worry is in managing expectations of outcome in an objective accountable manner.

But wait a minute. We just saw that placebos seem to work best when we are in the cognitive realm, as manifested by terms like suggestion, ritual, belief, and expectations.  Aren’t the placebo folks really arguing for a throwback to mind-body medicine? (Deepak Chopra started here and then found there were enough suckers to milk, with his spiritual nonsense, and has been happily laughing all the way to the bank ever since). Is the argument for mixing more psychologist style counseling as part of medical encounters?

But wait another minute. Don’t we live in a world filled with placebos: Astrology, Numerology, Superstitions, Miracles, and the biggest of them all God?


Written by asterix98

January 15, 2012 at 6:53 am

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