Homeopathy and placebo

Posted by Oliver on 12 March 2010 | 5 Comments

Tags: ,

The placebo effect is often dismissed as an annoying source of error in medical trials, when it is of course an amazing phenomenon. It shows how beliefs have an effect on our physical state, so much so that they can reduce pain and heal wounds. Perhaps medicine should be trying to harness the placebo effect, rather than trying to get rid of it.

So here is a thought experiment to ponder over. If you were given the task of developing a form of treatment that would harness the placebo effect, where would you start? Well, firstly you would have to devise something that would appear to be a medical treatment, but would have no direct physical effects at all. We know from countless medical trials that the activity of taking sugar pills that are thought to contain medical ingredients is an activity that elicits a strong placebo response. So introducing an impressive-looking range of pills that were nothing more than sugar pills would be a good option for a placebo-harnessing treatment.

In order to further enhance the medical credibility of the placebo-harnessing treatment, it would make sense to develop names for your pills. Latin-derivative names would be ideal, for they would give a strong sense of medical authenticity, let’s say one could use words like Belladonna, or Aconitum Napellus, or Pulsatilla. That would be perfect.

But in order to give your placebo-treatment the final seal of believability, you would need an answer to the patient’s possible questions of – how does it work? You would therefore need to think up a mechanism of action that was sufficiently vague to prevent further prying, but sufficiently credible to be acceptable. Perhaps one could draw on medical folklore and vaccination logic, and suggest that the treatment operates according to a ‘like-treating-like’. It may help to have a macroscopic amount of a naturally occurring substance in your sugar pill, so your placebo-harnessing ruse would not be too easily uncovered.

And the best bit is, we know for sure that the range of impressive-sounding pills would work! You would have thousands of satisfied patients walking away from your clinic feeling better thanks to the incredible power of placebo.

But before you embark on this, you think to yourself – would it be unethical to do this? There would be deception involved, and that is ethically highly suspect. However on the flipside you would be helping thousands of people to get better. And you would know that deception was essential to the placebo path of healing - if you did ever give the game away that your pills were operating through the process of belief rather than a physical process, then they would no longer work. So would your allegiance be to honesty, or to healing? I don’t think the answer is clear-cut.

As a caveat, I should say that I have no expertise in whether homeopathy is reliably better than placebo, and therefore is working via physical means, but if it was a ritualised placebo, it would still be a brilliant, if ethically ambiguous, idea.


Post your comment

Comments

  • What are your thoughts on this? Quoted:

    Clinical trials of homeopathic remedies sometimes show that these treatments work better than placebos. But a new analysis — comparing published studies of homeopathic drugs to matched, randomly selected studies of medical drugs — suggests that these apparent homeopathic drug effects are merely placebo effects.

    Matthias Egger, MD, director of the department of social and preventive medicine (ISPM) at the University of Berne, Switzerland, led the study. He notes that small studies of both homeopathic and medical drugs are prey to biases favoring positive results. Such studies, he says, show relatively large positive effects for both homeopathic and conventional medicines.

    But larger, more careful studies have fewer biases, Egger says. And these studies tell a different story.

    "The effect of homeopathy disappears if you look only at large, good trials; whereas the conventional medicines' effect is still there," Egger tells WebMD. "This means there is no difference between placebo and homeopathic remedies."

    Posted by gotomeeting, 05/10/2010 8:32pm (1 year ago)

  • As someone who treats using homeopathy I find the question of how it works comes into my mind every time i give a medicine. It still strikes me as implausible and a little scary. What is it that is being prompted to act to bring about restoration of health. Surely that poppy seed sized grain cannot carry the message it seems to. So if it all is a placebo, which I am open to it raises the question of what is happening in the organism? Why is there quite often an initial aggravation where symptoms get worse before getting better? Why do old previously treated symptoms sometimes appear and dissapear? Why do symptoms move from the more internal organs to the external? Why is it, when I give a medicine which does not match exactly the patients symptoms, do they start to experience symptoms never experienced before, that also were were reported by those who took the remedy to find out what it can be used for? I don't know how it or why it works, and to some extent it doesn't matter. Even if it is nothing but placebo, it doesn't take away from the fact that the responses of the organism to treatment are much more complex than we can imagine. It is more than just symptoms coming and going. There is an apparent order to what is taking place. The best description for homeopathy that I have come across is that it is like having a spring cvlean.

    Posted by paul, 02/04/2010 10:16pm (2 years ago)

  • I've just finished reading "Zero - the biography of a dangerous idea" by Charles Siefe published by Souvenir Press and was fascinated to learn a little (perhaps a little knowledge is a dangerous thing!) about the Casimir effect,

    " a mysterious, phantom force exerted by nothing at all...... It is a tiny force and very difficult to measure, but in 1995 the physicist Steven Lamoreaux measured the Casimir effect directly. ...... The answer - about the weight of one slice of an ant that's been chopped into 30,000 pieces... Lamoreaux had measured the force exerted by empty space."

    It seems that the behaviour of sub-atomic particles in the quantum zoo is equally mysterious as the relationship between homeopathic energy and our cellular structure.

    http://en.wikipedia.org/wiki/Casimir_effect

    Posted by Robert de Vos, 16/03/2010 2:06pm (2 years ago)

  • Oh, I've been wanting to sell Placebo Pills for quite a while now but I'm not sure how to market them. According to current statistics, 20% of subjects in double-blind drug trials receive the same benefits as the ones given the active ingredient. So I would be guaranteed a 20% success rate using a therapy which could sell for pennies. And no side-effects! I think it's all in the marketing.

    There are all sorts of "placebo" products on the market - tachyon cards.... quantum vortex accessories .... blessed religious relics ... shamanic products: animal/vegetable derivatives ... hypnotism... crystal pendants etc. etc. but having used only homeopathic medication for over 30 years, I'm reluctant to attribute only the placebo effect to this therapy; especially when it is being used very effectively with animals who haven't been told about the placebo effect.

    Of course this raises an even bigger problem: what if the animals pick up our "healing intentions" and get better because they want to please us?
    David Bohm said "Every action starts from an intention in the implicate order. The imagination is already the creation of the form; it already has the intention and the germs of all the movements needed to carry it out. And it affects the body and so on, so that as creation takes place in that way from the subtler levels in the implicate order, it goes through them until it manifests in the explicate."
    The Holgraphic Universe - Michael Talbot p83-84

    Perhaps it's like the Heisenberg Uncertainty Principle where we cannot measure both the velocity and the position of a particle at the same time.

    Posted by Robert de Vos, 16/03/2010 11:07am (2 years ago)

  • I think you have to distinguish between medical research, where you're trying to establish the biological efficacy of a particular molecule, and where you'd wish to eliminate the placebo effect (in all its multitudinous dimensions), and medical practice, in which you'd like to include as much of it as is ethical. The ethical point is slippery, but I think that lying about the efficacy of a treatment is on the wrong side of the line. Besides, if you practise deception, you're likely to be found out and then never trusted again. But there's much that can be done without going to this length. I start by simply trying to avoid the nocebo effect - that is having patients walk out feeling less happy than when they walked in - but there's much more on the positive side that can be achieved without deception. Into this also feeds the issue of knowledge and reassurance. The more knowledge a patient wants - and it's now easy to gain much of it from the internet, if not from the doctor himself - the less possibility there is for reassurance. If you know the full facts of your condition, reassurance becomes meaningless. Yet reassurance, when possible, might also improve your chances. So it's a tricky area which has to be played out skillfully.

    Posted by Dr Who, 13/03/2010 10:29am (2 years ago)

RSS feed for comments on this page | RSS feed for all comments