
The Placebo Effect Works and You Can Catch It from Your Doctor - pseudolus
https://www.npr.org/sections/health-shots/2019/10/21/772086920/the-placebo-effect-works-and-you-can-catch-it-from-your-doctor
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litnatpath
This is _literally_ the only reason nonsense like homeopathy “works”

Duh.

~~~
loceng
Do you think optimism and hope should be outlawed? I know it's an odd
question.

If a placebo "works" for some people - doesn't harm them, is relatively
inexpensive, is a free choice for them to make - should it be prevented?

~~~
08-15
> Do you think optimism and hope should be outlawed?

Irrelevant. But do I think _selling_ (nothing but) hope and optimism should be
outlawed? Hell, yes!

For anything else, you couldn't get away with this argument. You can't sell a
brick as a loaf of bread, knowing that it isn't nutritious, then claim that
what you really sold was "hope and optimism" for nutrition. It's fraud, no
matter what you call it.

> If a placebo "works" for some people - doesn't harm them, is relatively
> inexpensive

Yeah, "if". But it doesn't, it does, and it isn't. Placebo treatment is fraud,
plain and simple.

~~~
loceng
I don't think you understand what placebo is because placebo is all it takes
for someone to believe in (tied to optimism and hope that you're trying to
gate keep as irrelevant) for some people to feel benefit - regardless if
there's another mechanism causing that or not.

Otherwise apples to oranges comparison - we're not talking about anything
else.

~~~
08-15
You don't know if patients treated with a placebo feel a benefit, you only
know that they _report_ feeling a benefit.

What's the task of the physician? Is it to relieve the patient's pain or is it
to get the patient to shut up about his pain? Do you think there is a
difference?

------
08-15
> Chang says that the paper is evidence that subtle, nonverbal factors "can
> have a large impact on the experience of pain"

and Chang is wrong, wrong, wrong. The phrase should have been "can have a
large impact on _how_ the experience of pain _is reported_ ".

There is no evidence that the patient _actors_ experienced the pain any
differently, only that they reported differently on it. Who knows, maybe they
tried more to be good actors than they tried to be good patients?

Until a study shows up that _measures_ sham treatment to be more effective
than no treatment, I maintain that the placebo effect is simply regression to
the mean, or unreliable self reporting, and prescribing a placebo, or a
placebo under another name (homeopathy, alternative medicine, etc.) under any
circumstances is fraud and a violation of the Hippocratic Oath.

~~~
pella
> Until a study shows up that measures sham treatment

> to be more effective than no treatment,

Effectiveness of sham acupuncture (placebo) was almost twice that of
conventional therapy. (
[https://www.ncbi.nlm.nih.gov/pubmed/17893311](https://www.ncbi.nlm.nih.gov/pubmed/17893311)
)

what is the ethical decision according to Hippocratic Oath?

sham acupuncture (placebo) or conventional therapy ?

~~~
08-15
What was measured in that study and how? I can't see it from the abstract.

Edit: also, how's that relevant? Acupuncture and sham acupuncture are the very
same thing, so what's the placebo (no treatment) group here?

~~~
pella
[https://jamanetwork.com/journals/jamainternalmedicine/articl...](https://jamanetwork.com/journals/jamainternalmedicine/articlepdf/413107/ioi70115_1892_1898.pdf)

placebo acupuncture == sham acupuncture

placebo != no treatment

~~~
08-15
Actually, sham acupuncture == acupuncture. The study shows no significant
difference in effect between the two.

~~~
pella
""Sham acupuncture (SA), also called placebo acupuncture (PA)""

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749386/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5749386/)

