“People swear by these things,” he said. “Is it ethically correct to
allow patients to live in blissful ignorance? Or is it better to
provide them with the facts? We can’t deceive patients. We have to be
honest with them.”
Good news! The people who swear by these things aren’t going to believe your evidence anyway, so no harm done by sharing it.
They can just tell people about. In one study it was shown the placebo effect works even when people are told it is the placebo effect. Just tell people that the bracelets are a placebo that a lot of people believe in, and that if the bracelets seem to them like something they should try then they should go ahead and try the bracelet. Tell them that and nausea are both very good targets for placebos and that cancer and heart disease are not.
I wonder if the strength of the effect would decrease with patients who are researchers or statisticians. Probably not, since people tend to compartmentalize that kind of knowledge, but an intriguing question.
The marketers of these products claim they offer pain relief above the level of placebo. They don’t. That’s dishonest. How are you confused about this? I suggested 2 free placebos: “air breathed from a westerly direction” and “punch in the face from teapot”.
The placebo itself doesn’t matter, all that is required is for the person undertaking the treatment to believe it’s something effective. In any case this isn’t about offending my sense of rationalism: I accept that the placebo effect is a real thing. What I’m saying is the people who are profiting from these products make false claims about the effectiveness of their product. You may say that is necessary for people to even benefit from the placebo effect, but as I said: I and a bunch of other evidence-based medicine fans are not going to just sit back and relax while people make fraudulent claims about the health benefits of some bullshit.
I also call absolute bunk on the claim in your original comment that people receive “substantial” chronic pain relief as a result of the placebo effect. Show me any evidence to prove this. Placebo is a pathetic baseline when it comes to measuring the effectiveness of a treatment, one tiny step up from zero efficacy. Your adorable example situation is laughable because it doesn’t include Person C: the person who gets real pain meds. That person will feel even better than Person B because they’ve got the placebo effect and pharmaceutical benefits. Why does your view of potential treatments only include no treatment or placebo? I hope you never open a hospital.
Gluten free diets … all have a well established mechanism for them
to do something.
NOOOOOOOooooooooo!
In fact, gluten free diets are ONLY a necessity for people with celiac disease. FTFY
If you don’t have celiac disease don’t waste your time and money on gluten free foods and don’t waste your life eating crappily-textured, usually uninspiring foods.
Much as you might love to punch folks in the face, neither of your two free “placebos” are likely to cause the person undertaking the treatment to believe it’s something effective. Nor do we know the precise psychological mechanism of placebo: does it have to involve a physical object such a pill? Is it just the feeling of attention from the doctor? Do cultural beliefs play a role? Is it important that people feel validated in their beliefs? It’s not even clear that any deception is necessary as had been assumed, there’s been some interesting research into non-blind placebos, which avoid the ethical problems.
Nor, for that matter, person D, the person who gets both “real” (by which you really mean physiological) pain meds, and the copper bracelet placebo. If the copper bracelet with the fancy magnets and whatever really is a placebo for pain management, then person B does better than person A, and person D feels better than person C.
Bear in mind that for rheumatoid arthritis, the usual disease for which people resort to copper placebos, doesn’t really have good long-term pain management drug options.
@xeni I just wanted to add this is my favorite BB topic title yet. Every time I see it, I laugh. Fuckin’ magnets, man! 
I don’t see how wearing copper makes any more sense than my suggestions, especially when the data contradicts the claim. At least my remedies haven’t been thoroughly disproven.
Nice try on the misread there: unless you simply don’t understand the difference between your claim and those made in the link you posted. Your exact words were “for substantial chronic pain relief” and this link merely states that “effects on pain are substantial”. Providing “substantial chronic pain relief” and “having a substantial effect on pain” are two starkly different claims. Chronic pain is a VERY different thing to pain, by the way. Furthermore the pain source for the research you linked was “constant heat pain” - hardly comparable to the agony of arthritis.
I also take exception to your nonsense addition of Person D, unless you have some evidence to back it up. Every drug trial of every drug that has been shown to be effective looks like my example, whereas I’ve not personally seen any research that supports your Person D theory… if it exists show us. If not, stop just making up crap to support your argument.
PS: My comment also clearly refers to them as “pharmaceutical” benefits… I don’t need your corrections, thanks.
They haven’t been “thoroughly disproven”. They’ve just been shown to have no non-placebo effects. But there may be valuable placebo effects. You can point to as may studies as you like showing that something is no better than placebo; none of that says anything about whether the placebo is better than nothing.
How hard is this? “X is no greater than P” does not imply “P is no greater than zero”.
Now you’re nitpicking.
I have no idea how effective copper bracelets (with or without magnets) are as placebo. I do know, however, (1) placebo is effective for pain control in various ways, and (2) some people who wear them claim that they have less pain. Such people cannot reasonably be considered “suckers”, or “fucking idiots”, nor should you punch them in the face, for performing an action that in the end reduces their suffering. Nor is it necessarily preventing them from getting “real” treatment, when there’s no appropriate physiological option.
The problem is, your concept of “shown to be effective” means “better than placebo”. That tells us nothing about the value of the placebo. Specifically, “every drug trial of every drug that has been shown to be effective” compares C against B, more or less. Whereas for examining the placebo effect itself, we’d want to compare B with A and possibly also D with C. Your C is irrelevant without considering D.
none of that says anything about whether the placebo is better than nothing.
We have medicines with proven efficacy. There’s no need to rely on placebo. Is it fascinating? Maybe. Is the therapeutic value of placebo significant in comparison with the therapeutic benefit of pharmaceuticals? No.
You still don’t seem to be worried that the shills who sell these things make false and fraudulent claims about the healing benefits of their wares. Surely if you don’t have a problem with sham medicine, you at least have a problem with dishonesty in advertising?
And no… I’m not nitpicking. I quoted you, and then the article which you claim supports your argument. They aren’t even close and the best you can do is say I’m nit-picking? 1) As effetive as placebo. I’ll take the real deal thanks. It works better than positive thinking. 2) Thanks for their anecdotal evidence: evidence worth precisely ZERO. Real data of GTFO. There is nothing less accurate than a person’s subjective experience. I, quite reasonably, consider them idiots and suckers, as do others who respect evidence-based medicine. Please, list something, anything that doesn’t have a pharmaceutical with more efficacy than placebo. Good. Luck.
Keep trying guy. I’ve in no place said that the placebo effect isn’t real, I’ve just said that there are better treatments than mere placebo for basically any ailment you care to name. As I said before guy: your “D” is completely irrelevant until you show me one shred of evidence demonstrating that Person D had better outcomes than Person C in a situation like the one you describe. I simply don’t believe the additional effect of a placebo on top of standard treatment would even be measurable. These are your claims, not mine. Prove them.
Unless you bring any new info to this discussion, consider it over.
@AshleyYakeley I think you’d benefit greatly from listening to the offerings of a person who has spent their life studying these things:
QuackCast 5. Placebo Effect. Alt.med effects are often attributed to the placebo effect. Turns out the placebo effect does not exist. So when the effect of alt.med is equal to placebo effect, it is the same as saying it is equal to nothing. How true, how true. 5/22/06
There are a bunch of other podcasts on his site that deal with the medical literature that deals with placebo. Just do a pagesearch for ‘placebo’ http://edgydoc.com/references/
If a placebo treatment is advertised as “better than placebo”, that’s dishonest.
Umm… how many products do you see advertised as “as good as placebo”? None. All of these products make unfounded claims about their effectiveness. That is required for them to even work as placebo… you have to buy into the nonsense or it won’t work.
How do you think pain is measured scientifically?
In a systematic and measured way, not as unmeasured subjective observations at random times from random people. You said “some people who wear them claim that they have less pain” which is nothing but massively ambiguous, anecdotal evidence. That’s not science.
unless you also consider some person D
I’m willing to consider person D: As soon as you show me even one shred of evidence that a person who takes placebo and actual meds has better outcomes than the person who is only taking meds. Medicine and science isn’t about gut feeling, it’s about conclusive evidence. You’ve shown me none that indicate person D would have better outcomes than person C.
Do you have any evidence for this? Real data or GTFO.
Do you have any mental disorders I don’t know about? Funny you know how to copy, but you don’t copy the part which calls you on exactly that point: These are your claims, not mine. Prove them. The onus is not on me to prove a negative, the onus is on YOU to prove your idea is valid or worth considering. This is done by showing ME real data… so finally we agree on something: Real data or GTFO. It’s your move since it’s your claim.
Okay, here’s a few more that are popular in my circle. Explain the medical quasi relationship that seems more probable that magnet healing:
Foot baths that draw toxins out of your body (I argue that is stuff is leaking out of your foot you have a very serious medical condition).
I have a friend who is a Medical Intuitive - she can figure what’s wrong with you just by using her intuition.
Muscle testing, where you can tell how someone feels/if they are allergic by putting a substance, or a note with your intention on it, in your hand and then by the way your arm responds to the item you know whether it’s a thumbs up or thumbs down.
I agree about the quackery being sold in drugstores. It’s here, too. Homeopathic remedies or creams with herbs in them sold alongside the FDA approved medicines.
Same with doctors - a lot of this quackery is pushed by them as well. Money money money.
This is true and it also can be explained medically. The nerve response to pain has two components: the physical nerve sensation plus the mental perception of pain. If you can alter the mental perception of pain, you can lower the perceived amount of pain - that is, the pain. Placebos work well on this, as can breathing techniques, listening to music, lots of little tricks you can use. Chronic pain is much harder, I think - I have known a few people who live with ongoing pain and I don’t think the placebos have the same value for them as people with intermittent pain such as back pain that comes and goes.I think it’s hard to keep the attention fixed in such a way as to cope with the pain continuously.
Check out this book:
I agree with you that placebos likely have no benefit in combination with real drugs but that is only because real drugs are already real drugs + placebos if people think they are going to work. If people don’t have any faith in pills and do have faith in crystals, however, then they may be better off with a placebo they believe in (for the limited scope of things that placebos can actually help with).
You seem to think that placebos do next to nothing or are outclassed by far by real drugs. The reality is that they have been getting more and more effective (no one understands why) and that many real drugs that passed controlled tests some time back may not show any benefit above today’s somehow-more-effective placebos if they had to be retested. Many real drugs are barely better than placebos and have potential negative side effects that don’t outweigh that marginal benefit (placebos can have negative side effects too, but again, people can get those side effects from taking real drugs since real drugs double as placebos, and placebo side effects are person-dependent so a person who things pills are bad is more likely to have side effects).
Morphine works for real, but we aren’t going to walk around on morphine all the time. Tylenol for arthritis? Some people are going to get a good deal of pain relief and others are not. People who experience less pain wearing a copper bracelet should probably wear the stupid bracelet. I nearly pass out whenever I need a needle - should I say, “Well that’s just dumb, I’m going to ignore it” or should I tell the nurse I should probably lie down? Ignoring how your own body and brain react to stimuli sounds pretty stupid to me.
It’s also not fair to assume the manufacturers are charlatans, they may well be true believers. I’m not really sure which you would think is worse…
I think that it works in the opposite way… The more $$ (and BS), the more effect.
The placebo effect is not a sham, as you seem to accept elsewhere. As for advertising, it depends on the claim made. If a placebo treatment is advertised as “better than placebo”, that’s dishonest. If a placebo treatment is advertised as “better than nothing”, and there is a placebo effect for it, then that claim is true. So it can’t be considered dishonest, not even if the claim is self-fulfilling.
You’re still not getting it. Sometimes there’s no real deal available. Or sometimes there is, but it cannot be taken long-term, or there are bad side-effects, or they don’t help all patients. For example, pain management of rheumatoid arthritis. For example, fibromyalgia, for which cognitive behavioural therapy can help, if that counts as “positive thinking” (it’s rather more than that).
Hey, sometimes your kid gets a scrape and wants a band-aid, even though for that kind of bruise it won’t really help. But it makes him happy, he feels less suffering. That’s also the placebo effect. Sure, go ahead and inform him of the medical facts for his own education, but let him have the band-aid, or “kiss it better” or whatever makes him feel better, or you’re kind of an asshole parent.
Even though you seem to accept (?) that placebo can be effective for pain sometimes possibly maybe, you seem to be really really sure that it wouldn’t work in the specific case of long-term pain, to the point of calling anyone trying it a “fucking idiot” and “sucker” and the face-punching etc., even when they claim the treatment reduces their suffering.
Are you seriously suggesting that a person’s subjective experience of pain is not an accurate measure of how much pain they are feeling? What do you think pain is? How do you think pain is measured scientifically?
Why is someone an idiot or a sucker for acting in a way that reduces their suffering? And what, exactly, do you and your army of evidence-respecters consider to be “evidence” of pain, besides self-report of subjective experience?
Your person C is completely irrelevant for examining the placebo effect, unless you also consider some person D. That is all. If there is a suitable drug available, that’s great, but sometimes there isn’t.
Do you have any evidence for this? Real data or GTFO. If you’re going to be calling people idiots or suckers for taking some placebo treatment that they claim reduces their suffering, the burden of proof is on you to show that they are suffering just as much as they would without it, not on them (or me) to show that their subjective experience of pain reduction is real to your “evidence-based” satisfaction.
So your complaint is that it’s unethical to trade something that only has value because the holder believes it does for something that only has value because the holder believes it does?
Are you saying there is placebo money?
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