Destroying the placebo effect

Great Debates
1

This is a question with a few different moral and scientific angles, and it’s one that I need to act on, so I hope there can be some reasonable discussion.

There is a person I know who is in his mid-sixties, who is quite unwell. He has diabetes and a number of problems related to this, and recently he has had problems with his kidneys. His doctor told him that he will need to prepare for dialysis any week now.

He and his wife were at a party not long ago, and someone recommended a homeopath, who had apparently had miraculous results with different people she knew. So this man went to the homeopath, in the hope that there would be some way to stop him needing to go in for dialysis three times a week. His ‘treatment’ consists of the usual pills and drops in water, and so far (it’s been about six weeks), he seems to be at least staying steady, and he hasn’t needed dialysis.

I was talking to his wife, and commenting that I don’t hold much stock in homeopaths, naturopaths, etc (I kept getting an answer something like ‘oh, it’s naturopaths who are the charlatans, homeopaths know what they’re doing’). I’d just been reading an article linked to from this very message board about the problems with the theory behind heavily diluted medicine, so I had lots of material.

My question is, whether I should push the issue with him and his wife. I think they’re wasting money, time and energy by going to a homeopath, and although they’re keeping in touch with their real doctor and not throwing away other medication, I still feel scared about the effect this might have on him. On the other hand, if there is a placebo effect which is, at worst, making him feel better, am I being terrible by making them lose faith in what might help a little?

So what should I do - let ignorance reign and give him a chance to be happy for a while, or stamp out his hopes of a natural cure?

2

Some studies support the placebo effect as genuine, so, ergo it is a “valid treatment”. Check out “The Wonder Pill” at www.pbs.org for more info.

I figure, if it helps, why not? On the other hand, I really hate wasting money. It would be a shame for someone’s condition to deteriate while pursueing “fake” treatments when they could be getting “real” treatments.

Tough call.

Fagjunk Theology: Not just for sodomite propagandists anymore.

3

I think the water coming out of my facuet “remembers” being salt water once… so shouldn’t drinking it dehydrate me?

Seriously though, if all that’s being wasted is time and money (not health), i can think of a lot worse things it could be spent on than something that apparently gives them a good feeling, even if nothing else.

4

The Placebo effect can be very effective :slight_smile: so denying someone access to it would be bad. But it should never be expensive, and should be used in conjunction with actual medicines if there are any.
I used to read a lot of medical research papers on how a new treatment is tested against control groups of those receiving Placebo’s and those receiving no treatment. It always seemed that the placebo group did better than the non-treatment group. So go for it with the homeopathy ( = Placebo ) but do the conventional medical stuff as well.
Cheers, Bippy

5

Go find a PDR and look at the #'s from all the double-blind studies of each medicine (where a real pill is compared to a placibo vis a vis different symptoms/complaints from the subjects). The placebo effect is quite powerful. If someone believes that some snake oil is making them better, then as long as they’re not endangering themselves I wouldn’t worry about it.

6

However, a recent Danish study says the “placebo effect” has little effect.

HenrySpencer, I think you should encourage your friends to get real medical care and to shun the quacks.

7

Well, I had my doubts about homeopathic medicines, but my mom’s really into them, who was in turn gotten into it by a friend of hers that moved from South Africa.

They work. There is no placebo effect. They honestly do everything they’re touted to do. I have no friggin’ clue HOW they do it, but they do. All you do is dissolve under your tongue a little sugar pill that’s been soaked in an incredibly diluted natural substance.

How do I know it’s not a placebo effect? Well, for one thing, they work for animals. My mom’s friend from South Africa had a cat that was hit by a car. Instead of bringing it to the vet, she simply gave it the appropriate pills and it was up and about in weeks. She had a dog that developed some form of cancer. While the pills couldn’t cure it, they did help suppress these digusting sores on its skin. With regular dosage, the sores would be kept to minimal size, but if she missed a dose, they would bloom and explode, creating an ungodly stench. We give them to our cat to get rid of his worms, and it works every time. That doesn’t sound like a placebo to me.

Needless to say, homeopathics work on humans too. I haven’t been bed-ridden with illness for two years. I’ve had cuts and bruises disappear with astonishing speed. When I was in high school, my mom gave them to me to perk me up and shake off some of my normally sombre mood. While that last one may scream “placebo”, I’d give it the benefit of the doubt since there are so many visible effects of the various pills.

There are a couple downsides to homeopathy. First, it’s expensive. A vial of those little white balls will cost you quite a few bucks. Second, it’s not exactly as easy as taking a Tylenol. You have to figure out what your chemical disposition is and then crossreference that to whatever you’re trying to do. In other words, pills that do something for one person may have no effect, or an entirely different effect on someone else. It’s a complex system and you’ll probably need someone well-learned in the mechanics of it to get you started.

8

As a faithful reader of Skeptical Inquirer, allow me to just inform that poster of the conventions in discussing something like this…

ProjectOmega, around here you probably need to provide several links to scientific studies if you want to argue that a form of alternative medicine works. While I doubt that cats could benefit from a placebo effect, there could by any number of reasons the cat recovered, so one isolated incident isn’t very good proof. Considering that the general opinion of those in the know is that all these alternative medicines are naught but quackery, you have a higher burden of proof than merely anecdotal evidence can provide.

9

That’s not a valid proof. Placebo effect can work on animal owners.

10

Well, I honestly don’t want to bother with all the trouble of sifting through hundreds of wacky communing-with-the-animal-spirit websites, so you can take my experiences with homeopathy as you like. Trust me, I’m as skeptical as you get when it comes to “alternative” medicine. I made fun of my mom and refused to take her crazy “hippy pills” at first, but I couldn’t deny the effects. Even more astonishing was the fact that animals benefitted greatly from it.

And curing my cat of worms isn’t an isolated event; he gets worms, we fail to treat him, it can go on for months and months; if we start treating him, the worms are gone and his coat is silky in less than two weeks–this happens absolutely every time. The dog and his putrid skin blemishes weren’t isolated either.

11

I’d have to dispute that. When a cat has “worms”, there is a very visible clue to this: namely the white, maggot-ish worms crawling out of its rear end. As above, homeopathic treatment eliminates them in under two weeks in most cases, while going untreated usually means my cat can go months with these worms falling out of his ass. Unless these pills give off a high amount of radioactive hallucinogens that turn the worms invisible to my eyes, there is something very real about homeopathy.

12

I knew a woman with terrible bone cancer. The doctors gave her less than a year to live. She did every quack fad in the book, from shark oil to homegrown fungus. She lived for ten more years, until the day after her daughter graduated from high school. I doubt the fungus did anything for her body, but it did just enough for her soul.

I’d argue that as long as the quackery isn’t keeping them from seeking neccesary conventional medicine, it is actually unethical to try to tear down their beliefs.

13

Think about it. Placebos have to do with faith. It is faith that changes things.

Now that thought should get a lot of negative responses on this board.

14

leakatt- “can… opened… worms… everywhere…”

ahem.

Back when I was a CNA in Montana, we had a lady who every night got a “sleeping pill” which was comprised of sugar free Jell-O powder in a gel-cap.

She would holler if we didn’t give it to her, and she wouldn’t be able to sleep. Give her the pill, and she’d be out in 15 minutes.

Placebo’s do work, although I’m not about to hazard a reason why.

15

If I understand homeopathic theory, the water should actually provide the opposite effect than what it has a “memory” of, so the water whould actually hydrate you.

And what do you know, the water from the tap DOES hydrate me! Maybe I was wrong being skeptical about this thing… :wink:

16

Re: the OP

It’s hard to weigh the placebo benefit vs. the cost, especially since we don’t know how much they are spending or their financial situation. Unless it’s causing real financial distress, maybe the benefit outways the cost, even if it’s just hope.

17

Looking through the Danish article cited by December, there are clearly different types of placebo effect, some of which certainly exist and some of which almost certainly don’t. There is the reporting effect, where a patient or subject tells the doctor that he/she feels better to please the doctor, although they don’t feel better. One might also sincerely believe that a treatment has relieved pain even though it doesn’t because you believe that the pain would have been worse without the treatment. Both of these seem to me very likely to exist.

There is the possibility that pain actually is reduced by believing in the treatment. Similarly a person might sleep better given a placebo just because they are less worried about getting to sleep. I’m not sure these effects are real, but they are pretty plausible.

What I doubt would be real, would be a placebo actually curing a disease with physical causes, like kidney disease. I suppose a false belief in its effectiveness might reduce stress slightly resulting in the body fighting the problem a little better, but I doubt this would help much, and it could be very bad if it resulted in putting off a real effective treatment.

As far as homeopathy is concerned, the theory behind it is so utterly illogical it would have to pass numerous very rigorous controlled tests and be thoroughly replicated before I would find it at all plausible. From what I have seen of casual observations of alternative medicine effectiveness, there are usually ways to find excuses when the treatment fails, but always assign credit when the condition improves, even if there is a significant time delay after giving the treatment. I would guess this sort of thing, together with a bit of coincidence, would explain the cat success better than treatment with water.

18

Just FYI, feline tapeworms will go away eventually, once the life cycle of fleas (the carrier) is broken. Anyway, why apply a (probably) costly placebo when a 49¢ pill will do the job in a single dose?

19

Homeopathy isn’t placebo, that’s not its mode of action. The diluted effects of the active ingredient do work. I would also say that the power of thought or faith, call it what you will, does have effects which is why your reaction to stress can ultimately harm you.

Here are some studies of homeopathy vs placebo

20

The case studies cited by Project Omega have no value here.

I agree with those who say not to interfere. Call it a placebo effect or what you will, the patient’s state of mind affects their health.

On the other hand if we were talking about ‘supplements’, AKA unregulated drugs (like ephedrine) I would encourage the perosn to consult with their MD. Some supplements actually have physiological activity, meaning that they can have interfere with medical treatment or have interactions with prescription drugs. But homeopathic stuff is usually administered in such small quantities that this is not a concern.

RE: Danish study. It’s not a great idea to trust the press to interprect medical papers correctly-- even excellent papers like the Washington Post. I’ll try to post an assessment of the paper this weekend.