Religious rituals in healthcare

[Gaest]

Support? Medical school education.

Care to elaborate on this argument from authority?

More than just reading articles looking for any kind of support that use of placebo effect by medical practitioners should be considered legitimate.

Okay. So what are the problems with the articles I quoted? Did I misrepresent them? Or are there something significant wrong with them?


With regards to the two blogposts you gave: I pulled out the suff that seemed most relevant, but if there's anything else in there you want me to comment on you'll have to quote it.

Edit: more reading for you: https://sciencebasedmedicine.org/placebo...omeopathy/

(…)Smith then raises the ethical appropriateness of a key component of successful placebo use: in order for placebos to work, patients must believe something that is untrue

Not necessarily. Studies have showed that open-labeled placebos can have a significant effect as well.

“Although Maxalt was superior to placebo under each type of information, we were surprised that the efficacy of Maxalt mislabeled as placebo was not significantly better than the efficacy of placebo mislabeled as Maxalt. We were also surprised to find that open-label placebo treatment induced pain relief as compared with the worsening of pain during the untreated attack. A therapeutic benefit of open-label placebo versus no treatment was also recently reported for patients with irritable bowel syndrome in a randomized controlled study (8) and in a pilot study in depression (9).
(…)
Because our study used deception, its applicability to routine clinical care is limited, and the present findings are essentially a proof of concept. It would be important to expand our findings with experimental manipulations of expectancy considered ethical in clinical practice.
(…)
In conclusion, positive information about active medication contributes to successful treatment of episodic migraine. Medication and information (which presumably influences expectancies) may be equally critical for pain relief. The benefits of placebo persist even if placebo treatment is honestly described. Whether treatment involves medication or placebo, our study clearly shows that the information provided to patients and the predictable ritual of pill taking are important components of care (21). Further research is warranted to investigate the application of our findings to clinical practice and research design.”

Kam-Hansen, S., Jakubowski, M., Kelley, J. M., Kirsch, I., Hoaglin, D. C., Kaptchuk, T. J., et al. (2014). Altered placebo and drug labeling changes the outcome of episodic migraine attacks. Science Translational Medicine, 6(218), 218ra5-218ra5. doi:10.1126/scitranslmed.3006175

Obviously there is still a long way, but there are studies with results entertaining the possibility of ethically using placebos in treatment.

But what about placebo use by health professionals? While routine use of placebos wouldn’t be considered ethically acceptable, Smith notes that reinforcing the efficacy of a conventional medication, in a way that could enhance potential placebo effects, is acceptable. This is a routine part of the pharmacist’s dialogue with patients – understanding and addressing concerns, summarizing therapeutic effects, and managing overall treatment expectations. It can be done in a non-deceptive way that should maximize the non-specific effects.

Perhaps there may yet emerge a framework where placebos can be ethically (and judiciously) justified. Homeopathy isn’t it.

So following your source here: Maybe placebo can be a legitimate part of medicine.

Since you seem to like reading:

http://www.livescience.com/51421-should-...thics.html

But then, the tide turned, again, with a study published in The New England Journal of Medicine in 2001 by Dutch researchers, who found that most placebo studies were methodologically flawed. With a rub to Beecher, their paper was playfully titled "Is the Placebo Powerless?"


Kaptchuk has claimed in previous interviews to have learned much from the Dutch study and has since collaborated with one of the Dutch authors.

First of all, the researchers are obviously Danish – with Hróbjartsson probably having some kind of Icelandic or Faeroese origin. Not that it’s important, but it doesn’t exactly instill confidence in his claims...

The weird part here is that Wanjek follows that up with a “Kaptchuk has claimed”, and then he doesn’t go through any of the points of criticism and doesn’t investigate whether Kaptchuk has learned from them and included it in his later studies and articles.

Nevertheless, there are many critics of using placebos in medical care. In a 2011 article in The Atlantic, in reaction to a study that Kaptchuk conducted on asthma, retired family physician Harriet Hall said, "Asthma can be fatal. If the patient's lung function is getting worse, but a placebo makes them feel better, they might delay treatment until it is too late."

While Harriet Hall might have a point, this is not so much a general criticism as a pretty specific one… And there are varying severities of asthma – speaking as one who had problems with asthma as a kid, but was never in danger of dying.

But critics argue that placebo effects tend to be small, temporary and inconsistent, and that they have little proven positive effect on disease outcome, which should be the ultimate goal.

Which critics and what arguments? Again we're not given a lot of information. IMO this article is a bit underwhelming when it comes to arguing against what I have brought up in this thread…

Got no idea what the "Erh" comment means. Care to communicate better?

Yes, it was meant as a softer version of “meh”.