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Placebos can also work in reverse - if you strongly believe a medication or procedure is harmful then you will be harmed by it. That's why it's entirely unethi

Placebos can also work in reverse - if you strongly believe a medication or procedure is harmful then you will be harmed by it. That's why it's entirely unethical to force a medical product on a population. Take for example the mRNA covid vaccine. Let's say it did what they claimed at the start and stopped transmission 100% without ever causing a side effect. Even then, the emotional distress and reverse placebo effect of coercing people to take a vaccine if they don't want it still outweighs any benefit. People who believe a vaccine is dangerous but take it to save their job will get harmed whether it caused a side effect or not. The emotional distress alone can be debilitating. If the mind is so powerful it can strongly affect health outcomes, how could anyone think it's ethical to punish someone for making their own medical decision?

lazyasciiart 3y ago
Because their emotional distress and placebo effects don’t outweigh the benefit to everyone else of having them vaccinated. And requiring vaccination to keep your job is not a punishment, any more than we punish people with epilepsy by saying they can’t drive. It’s an attempt to reduce the risk to society posed by their medical state.
- em-bee 3y ago
  what's more, the distress is not caused by facts but by misinformation and people deliberately causing a scare. car traffic is more dangerous than the vaccine yet rarely is anyone experiencing distress over that.
piotrkaminski 3y ago
> Even then, the emotional distress and reverse placebo effect of coercing people to take a vaccine if they don't want it still outweighs any benefit. That's ridiculous -- of course benefits can outweigh psychological side-effects. Usually you'd want those benefits to accrue to the person suffering the side-effects, but living in a civilized society means accepting that sometimes the good of the many outweighs the pain of the few. If a vaccine for a deadly, highly communicable disease can completely stop transmission then I think it's perfectly ethical to require everyone to accept it or isolate from those willing to do so.
- bandofthehawk 3y ago
  > That's ridiculous -- of course benefits can outweigh psychological side-effects. I understood the grandparent post to mean that the harm can sometimes outweigh the benefits when the vaccine is forced. Not that it's always the case. > If a vaccine for a deadly, highly communicable disease can completely stop transmission Are you suggesting that the COVID vaccines were able to completely stop transmission?
  - piotrkaminski 3y ago
    > I understood the grandparent post to mean that the harm can sometimes outweigh the benefits when the vaccine is forced. Not that it's always the case. On careful re-reading I believe you're correct. Though if a hypothetical 100% effective zero side-effects vaccine doesn't pass their bar of outweighing psychological harm then it seems unlikely anything could, hence my interpretation of GP as an absolute statement. > Are you suggesting that the COVID vaccines were able to completely stop transmission? Hah, I wish! No, just going with the GP's hypothetical.
  - Kokouane 3y ago
    Parent comment seems completely hypothetical so this seems like a bit of a stretch.
- mistermann 3y ago
  > If a vaccine for a deadly, highly communicable disease can completely stop transmission then I think it's perfectly ethical to require everyone to accept it or isolate from those willing to do so. Did you consider the law of unintended consequences?
PaulDavisThe1st 3y ago
> Let's say it did what they claimed at the start and stopped transmission 100% This claim was never made. No vaccine works 100%, ever.
burkaman 3y ago
This is called the nocebo effect, and it is well-studied. Example: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788172 https://jamanetwork.com/journals/jamanetworkopen/fullarticle.... When you think of an interesting idea like this, please don't assume you've discovered something new that the entire public health field is unaware of. A drug or treatment that had worse nocebo effects than medical benefits would not be approved.
- halfjoking 3y ago
  I don’t agree that the nocebo effect can be tested in a clinical trial which only has willing participants. If there was a person who’d rather take a bullet than the vaccine, don’t you think the nocebo affect would be stronger? My feeling is anyone who requests an exemption due to their beliefs should be given it because you can’t measure the resoluteness of their beliefs, religious or not.
- NoZebra120vClip 3y ago
  I can testify to nocebo effect. Psychiatrists cannot/will not tell patients what primary effects we can expect from a given medication: "it works differently for everyone" "brain chemistry is unique" "it'll keep you out of the hospital" etc. The truth is that most psychotropic medications tend to induce altered states of consciousness, and yes, they can be different for different people, but these altered states are not published, touted, explained, or offered to patients or consumers of the medications. Only the adverse side effects are discussed (and if only we had a nickel for every time a prescriber told us "this has no/fewer side effects!") Therefore, we have not been informed of any primary effect for these drugs, and thus they can have no placebo effect. We do not "know" how we are "supposed to feel" while taking them. Since many have had psychiatric symptoms since childhood, we don't know any other mood or state of mind. How can we know if these effects have receded? Brain scan? Checklist? So we can't have a placebo effect. If we are well-informed of the side effects, we may notice some. We complain about side effects and the psychiatrist does a switcheroo and produces a second, third, fifth, tenth medication cocktail. "Just some adjustment until the benefits outweigh the risks." And they do this slowly, judiciously, one at a time, unless you land in the hospital. Psychotropic prescription drugs that are not Scheduled are weaksauce. And they're the only ones that can be prescribed to the poor and the needy and the homeless. Unless they're in the hospital. Therefore, you crank them up one at a time until the side effects are only mildly annoying, then you keep adding more drugs as the patient complains about symptoms. Without knowing any placebo effect. Perhaps this is one reason why psychedelic drugs are highly touted by some now. There has been much study done by recreational users of drugs. They all know how LSD will make you feel! They know how you can get on mescaline before/while you puke! So perhaps that's the answer: that formerly recreational drugs can come find a home with placebo, and primary, effects intact.
lifeformed 3y ago
Your fallacy is implying that the harms are equal. The nocebo effect from a vaccine is not more harmful than the benefits it gives to the person and to the society.
smrtinsert 3y ago
> the emotional distress and reverse placebo effect of coercing people to take a vaccine if they don't want it still outweighs any benefit In a very hamfisted comparison, if the expected death rate is 1% then the expected deaths are > 3 million in the US. I think this outweighs nocebos.
ChrisClark 3y ago
> Let's say it did what they claimed at the start and stopped transmission 100% without ever causing a side effect. Lying does not help your argument.

lazyasciiart 3y ago

Because their emotional distress and placebo effects don’t outweigh the benefit to everyone else of having them vaccinated. And requiring vaccination to keep your job is not a punishment, any more than we punish people with epilepsy by saying they can’t drive. It’s an attempt to reduce the risk to society posed by their medical state.

em-bee 3y ago
what's more, the distress is not caused by facts but by misinformation and people deliberately causing a scare. car traffic is more dangerous than the vaccine yet rarely is anyone experiencing distress over that.

piotrkaminski 3y ago

> Even then, the emotional distress and reverse placebo effect of coercing people to take a vaccine if they don't want it still outweighs any benefit. That's ridiculous -- of course benefits can outweigh psychological side-effects. Usually you'd want those benefits to accrue to the person suffering the side-effects, but living in a civilized society means accepting that sometimes the good of the many outweighs the pain of the few. If a vaccine for a deadly, highly communicable disease can completely stop transmission then I think it's perfectly ethical to require everyone to accept it or isolate from those willing to do so.

bandofthehawk 3y ago
> That's ridiculous -- of course benefits can outweigh psychological side-effects. I understood the grandparent post to mean that the harm can sometimes outweigh the benefits when the vaccine is forced. Not that it's always the case. > If a vaccine for a deadly, highly communicable disease can completely stop transmission Are you suggesting that the COVID vaccines were able to completely stop transmission?
- piotrkaminski 3y ago
  > I understood the grandparent post to mean that the harm can sometimes outweigh the benefits when the vaccine is forced. Not that it's always the case. On careful re-reading I believe you're correct. Though if a hypothetical 100% effective zero side-effects vaccine doesn't pass their bar of outweighing psychological harm then it seems unlikely anything could, hence my interpretation of GP as an absolute statement. > Are you suggesting that the COVID vaccines were able to completely stop transmission? Hah, I wish! No, just going with the GP's hypothetical.
- Kokouane 3y ago
  Parent comment seems completely hypothetical so this seems like a bit of a stretch.
mistermann 3y ago
> If a vaccine for a deadly, highly communicable disease can completely stop transmission then I think it's perfectly ethical to require everyone to accept it or isolate from those willing to do so. Did you consider the law of unintended consequences?

PaulDavisThe1st 3y ago

> Let's say it did what they claimed at the start and stopped transmission 100% This claim was never made. No vaccine works 100%, ever.

burkaman 3y ago

This is called the nocebo effect, and it is well-studied. Example: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788172 https://jamanetwork.com/journals/jamanetworkopen/fullarticle.... When you think of an interesting idea like this, please don't assume you've discovered something new that the entire public health field is unaware of. A drug or treatment that had worse nocebo effects than medical benefits would not be approved.

halfjoking 3y ago
I don’t agree that the nocebo effect can be tested in a clinical trial which only has willing participants. If there was a person who’d rather take a bullet than the vaccine, don’t you think the nocebo affect would be stronger? My feeling is anyone who requests an exemption due to their beliefs should be given it because you can’t measure the resoluteness of their beliefs, religious or not.
NoZebra120vClip 3y ago
I can testify to nocebo effect. Psychiatrists cannot/will not tell patients what primary effects we can expect from a given medication: "it works differently for everyone" "brain chemistry is unique" "it'll keep you out of the hospital" etc. The truth is that most psychotropic medications tend to induce altered states of consciousness, and yes, they can be different for different people, but these altered states are not published, touted, explained, or offered to patients or consumers of the medications. Only the adverse side effects are discussed (and if only we had a nickel for every time a prescriber told us "this has no/fewer side effects!") Therefore, we have not been informed of any primary effect for these drugs, and thus they can have no placebo effect. We do not "know" how we are "supposed to feel" while taking them. Since many have had psychiatric symptoms since childhood, we don't know any other mood or state of mind. How can we know if these effects have receded? Brain scan? Checklist? So we can't have a placebo effect. If we are well-informed of the side effects, we may notice some. We complain about side effects and the psychiatrist does a switcheroo and produces a second, third, fifth, tenth medication cocktail. "Just some adjustment until the benefits outweigh the risks." And they do this slowly, judiciously, one at a time, unless you land in the hospital. Psychotropic prescription drugs that are not Scheduled are weaksauce. And they're the only ones that can be prescribed to the poor and the needy and the homeless. Unless they're in the hospital. Therefore, you crank them up one at a time until the side effects are only mildly annoying, then you keep adding more drugs as the patient complains about symptoms. Without knowing any placebo effect. Perhaps this is one reason why psychedelic drugs are highly touted by some now. There has been much study done by recreational users of drugs. They all know how LSD will make you feel! They know how you can get on mescaline before/while you puke! So perhaps that's the answer: that formerly recreational drugs can come find a home with placebo, and primary, effects intact.

lifeformed 3y ago

Your fallacy is implying that the harms are equal. The nocebo effect from a vaccine is not more harmful than the benefits it gives to the person and to the society.

smrtinsert 3y ago

> the emotional distress and reverse placebo effect of coercing people to take a vaccine if they don't want it still outweighs any benefit In a very hamfisted comparison, if the expected death rate is 1% then the expected deaths are > 3 million in the US. I think this outweighs nocebos.

ChrisClark 3y ago

> Let's say it did what they claimed at the start and stopped transmission 100% without ever causing a side effect. Lying does not help your argument.