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Homeopathy is total BS, but the placebo effect is real. Is there a way that medical science can allow people to benefit from the latter without rewarding quacks

Homeopathy is total BS, but the placebo effect is real. Is there a way that medical science can allow people to benefit from the latter without rewarding quacks who push the former?

exe34 2y ago
prescribe distilled water.
- munchler 2y ago
  Right, but how to do this while preserving the placebo effect? If the patient knows it’s “just” water, the effect is lost. Some sort of deliberate deception seems to be necessary, which raises ethical problems.
  - exe34 2y ago
    I've found placebos work really well on me even when I know they're placebos.
ravi_m 2y ago
Yeah, homeopathy works due to the placebo effect and further boosted by people that subscribe to the anti-allopathic or Western medicine religion. I think it should be studied similar to how people go to Godmen for healing and report success stories - placebo effect + religious faith / belief.
skrebbel 2y ago
I’ve never understood why this isn’t explored more. It’s like, at some point we discovered the placebo effect, which has got to have been a pretty shocking result, right? I just can’t fathom that the entire scientific community just went “ah, hm, right, placebo. I see. I guess we need to do our random-controlled-trials with a placebo control group now”. Wait, that’s it? Nobody went “wtf woa we can cure a % of people with empty pills, how does that work and how can we up the %?” I just don’t get it, it seems to me that the existence of the placebo effect is hard evidence that there’s a mind-body connection and we can cure body stuff with mind stuff (and vice versa, probably), so why does nearly all of that remain firmly in alternative woo-woo land?
- vikramkr 2y ago
  Because prescribing a placebo while saying it's a medicine involves lying to the patient, which is controversial when ethical standards usually involve informed consent and a belief in patient autonomy. > I just can’t fathom that the entire scientific community just went “ah, hm, right, placebo. I see. I guess we need to do our random-controlled-trials with a placebo control group now”. Wait, that’s it? see that's because they didn't go like that - there's even an section on the ethics of using them in medical practice on the wikipedia article for placebo: https://en.wikipedia.org/wiki/Placebo#In_medical_practice https://en.wikipedia.org/wiki/Placebo#In_medical_practice Plus it's a pretty important topic of discussion when it comes to pain management/opiod crisis. Unsurprisingly, a large group of professionals did not, in fact, randomly decide to ignore a very large and obvious question in the field
  - skrebbel 2y ago
    You’re talking about the ethics of giving patients placebo medicine. That’s not what I mean. I mean that I don’t understand why there isn’t more research into how the placebo effect works and whether there’s ways to make it work better. Reading other sections of the wikipedia article you linked, it seems to me that researchers have been stuck at “is the placebo effect even real?” for decades and few try to figure out how it works and why, and whether it can somehow be amplified. The answers to such questions might well influence the ethics discussion but “we really don’t get how it works so better not prescribe placebos” is a very unsatisfying stance to me.
atombender 2y ago
The placebo effect and the biological basis for it is absolutely being seriously studied. You might be interested in the work of Ted Kaptchuk and Kathryn Hall [1], for example. (Kaptchuk is a trained acupuncturist with a degree in Chinese medicine, but basically re-educated himself in western medicine, and is a highly regarded scientist.) One of their insights is that placebo effect comes from neural modulation of pain receptors, and that the placebo effect has specific limitations. For example, the placebo effect cannot cure cancer or make a cold go away, but it can lessen pain and reduce inflammation through hormone signaling. [1] https://www.harvardmagazine.com/node/39354 https://www.harvardmagazine.com/node/39354

Homeopathy is total BS, but the placebo effect is real. Is there a way that medical science can allow people to benefit from the latter without rewarding quacks who push the former?

exe34 2y ago

prescribe distilled water.

munchler 2y ago
Right, but how to do this while preserving the placebo effect? If the patient knows it’s “just” water, the effect is lost. Some sort of deliberate deception seems to be necessary, which raises ethical problems.
- exe34 2y ago
  I've found placebos work really well on me even when I know they're placebos.

ravi_m 2y ago

Yeah, homeopathy works due to the placebo effect and further boosted by people that subscribe to the anti-allopathic or Western medicine religion. I think it should be studied similar to how people go to Godmen for healing and report success stories - placebo effect + religious faith / belief.

skrebbel 2y ago

I’ve never understood why this isn’t explored more. It’s like, at some point we discovered the placebo effect, which has got to have been a pretty shocking result, right? I just can’t fathom that the entire scientific community just went “ah, hm, right, placebo. I see. I guess we need to do our random-controlled-trials with a placebo control group now”. Wait, that’s it? Nobody went “wtf woa we can cure a % of people with empty pills, how does that work and how can we up the %?” I just don’t get it, it seems to me that the existence of the placebo effect is hard evidence that there’s a mind-body connection and we can cure body stuff with mind stuff (and vice versa, probably), so why does nearly all of that remain firmly in alternative woo-woo land?

vikramkr 2y ago
Because prescribing a placebo while saying it's a medicine involves lying to the patient, which is controversial when ethical standards usually involve informed consent and a belief in patient autonomy. > I just can’t fathom that the entire scientific community just went “ah, hm, right, placebo. I see. I guess we need to do our random-controlled-trials with a placebo control group now”. Wait, that’s it? see that's because they didn't go like that - there's even an section on the ethics of using them in medical practice on the wikipedia article for placebo: https://en.wikipedia.org/wiki/Placebo#In_medical_practice https://en.wikipedia.org/wiki/Placebo#In_medical_practice Plus it's a pretty important topic of discussion when it comes to pain management/opiod crisis. Unsurprisingly, a large group of professionals did not, in fact, randomly decide to ignore a very large and obvious question in the field
- skrebbel 2y ago
  You’re talking about the ethics of giving patients placebo medicine. That’s not what I mean. I mean that I don’t understand why there isn’t more research into how the placebo effect works and whether there’s ways to make it work better. Reading other sections of the wikipedia article you linked, it seems to me that researchers have been stuck at “is the placebo effect even real?” for decades and few try to figure out how it works and why, and whether it can somehow be amplified. The answers to such questions might well influence the ethics discussion but “we really don’t get how it works so better not prescribe placebos” is a very unsatisfying stance to me.

atombender 2y ago

The placebo effect and the biological basis for it is absolutely being seriously studied. You might be interested in the work of Ted Kaptchuk and Kathryn Hall [1], for example. (Kaptchuk is a trained acupuncturist with a degree in Chinese medicine, but basically re-educated himself in western medicine, and is a highly regarded scientist.) One of their insights is that placebo effect comes from neural modulation of pain receptors, and that the placebo effect has specific limitations. For example, the placebo effect cannot cure cancer or make a cold go away, but it can lessen pain and reduce inflammation through hormone signaling. [1] https://www.harvardmagazine.com/node/39354 https://www.harvardmagazine.com/node/39354