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Diluted sugarDiluted sugarPosted Aug 18, 2012 17:40 UTC (Sat) by giraffedata (subscriber, #1954)In reply to: Diluted sugar by anselm Parent article: Garzik: An Andre To Remember
In spite of vast numbers of trials there is no evidence whatsoever that homeopathy works better than placebos But placebos work, on some people. Is it possible a practicioner can legitimately heal someone by prescribing a homeopathic treatment that the patient can read about on the web and develop some faith in? There is a recognized ethical quandary over whether prescribing placebos is unethical, especially considering that for them to be effective, they typically have to be expensive. Speaking of placebos, I'll always remember looking at a box of minoxidil hair regrowth medication. It said something like 35% of subjects reported hair regrowth using the drug vs 25% for placebo. It was very expensive and my first thought was, "I'll take the placebo. Sounds like a better deal."
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Diluted sugar Posted Aug 18, 2012 20:28 UTC (Sat) by man_ls (subscriber, #15091) [Link] Minoxidil is a funny example of "scientific" medicine: it was discovered by chance, it only works on some people, the mechanism by which it works is unknown, and all of its effects are reversed if the patient stops using it. But still it is used, as it is the only known medicament which stops hair loss effectively.The percentages of success vary, but hair growth is not usual; rather it stops hair loss. It is there where placebos may be some competition and not in growth, since if placebos caused hair growth they would sell like crazy.
Diluted sugar Posted Aug 19, 2012 21:24 UTC (Sun) by anselm (subscriber, #2796) [Link] Placebos "work" for some people because many ailments people suffer from will tend to go away if they are left alone long enough. Consider, for example, the common cold, which so far has resisted the efforts of scientific medicine, but for which your friendly neighbourhood homeopath will be more than happy to prescribe some sugar pills at an outrageous price (for sugar). It doesn't matter if you take the sugar pills because they will neither help or hinder your getting better. However having taken the sugar pills you are likely to give them the credit. It is even likely that your symptoms will get worse after you have started the sugar pills, since they don't do anything, which homeopaths will conveniently explain away as the effect of the medication getting to work inside you. Many other ailments people suffer from (e.g., chronic back pain, which scientific medicine has so far also failed from curing conclusively) tend to come and go, and since people are apt to go to the doctor (or homeopath) when their complaints are worst, even sugar pills will seem to help because of "regression to the mean" (you would have come out of the bad phase into a somewhat better phase, anyway). Then of course there are those ailments that have a good chance of killing you when they remain untreated, like malaria or cancer. This is something that "ethical" homeopaths shouldn't touch with a 10' pole. If only they would. The BBC has found in an experiment that a vast majority of homeopathic pharmacies in London will be more than happy to sell you "homeopathic" malaria "prophylaxis", and one homeopathic remedy for cancer is sugar pills with hyper-diluted extract of mistletoe (i.e., no mistletoe), on the grounds - and I am not making this up - that mistletoe looks like cancer on trees. The problem with stuff like homeopathy is that the placebo effect is a lot less powerful if your medical practitioner tells you that there's nothing in the pills except sugar, that they have not been able to be proven to work in clinical trials, and that indeed they have no conceivable way of doing anything to you as far as our concepts of physics, chemistry and biology go. Which is, perhaps understandably, why most people dealing in homeopathy neglect to explain this to their patients. In effect, they are being knowingly dishonest to their patients, which is unacceptable. Personally, I would have much less of a problem being told that there is no remedy against my cold that has been shown to work, but that the cold will almost certainly get better anyway, than being prescribed very expensive sugar pills or (for that matter) antibiotics (which too many non-homeopathic practitioners are prone to do, but that is a different problem).
Diluted sugar Posted Aug 19, 2012 22:56 UTC (Sun) by giraffedata (subscriber, #1954) [Link] No, that's not the placebo effect. The fact that things get better in time without treatment is a big reason that the control group reports improvement, but it isn't what people refer to as the placebo effect. The placebo effect is where a person's subjective evaluation of his health improves when he thinks he is being treated. The placebo doesn't cause his rhinovirus count to go down, but it makes him feel better. When you consider that the real reason most people go to the doctor is to feel better, not to effect a particular biological change in the body, you have to say a placebo is effective in that case. In fact, you could argue it's unethical to withhold a placebo. The placebo effect is very real. I have a friend who is extremely susceptible to it, not just in medicines, but in everything else. If he installed a new wireless access point, especially if it were expensive, he would report faster web browsing even if the actual speed was unaffected. (He's not the type to measure it, of course).
Sorry for the off-topic Posted Aug 19, 2012 23:10 UTC (Sun) by man_ls (subscriber, #15091) [Link] In fact, you could argue it's unethical to withhold a placebo.That argument could even be a suitable justification for homeopathic medicine. I am not sure if you want to go there. The thing is that the Hippocratic Oath specifically says "never do harm", but not "avoid useless treatments". It could be argued that using the placebo effect can sooth both patients and their families, in cases where there is no known cure. Sugar pills cannot do any harm... On the other hand, spreading unscientific theories is a much worse sin in my opinion.
Sorry for the even-more off-topic Posted Aug 19, 2012 23:28 UTC (Sun) by neilbrown (subscriber, #359) [Link]
> On the other hand, spreading unscientific theories is a much worse sin in my opinion.
You seem to be spreading the theory that "spreading unscientific theories is harmful".
Just curious...
Sorry for the even-more off-topic Posted Aug 20, 2012 0:04 UTC (Mon) by man_ls (subscriber, #15091) [Link] Thanks for the recursive laugh, I always appreciate those :)Anyway, I don't have any scientific basis to dislike unscientific theories, but I am not right now speaking from an office which is (or should be) based on science. If a professor of Astronomy spoke about the horoscope I would start to worry... And I am not a medical practitioner, thank god, since I think it is one of the hardest professions. From medical practitioners I expect to get at least a plausible explanation of the causes, or (as in the case of Minoxidil above) an experimental confirmation. We should require both, but life is tough. With homeopathy there are neither, and therefore the iniquity. To bring this long thread at least a bit back into topic, the psychiatric profession has made wonderful advances both in the determination of the root causes of mental illnesses, and in the experimental treatment of those. If you don't feel well, please go to a doctor (a psychiatrist) in addition to a psychologist.
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