--- On Thu, 5/28/09, Gilbert Lawrence <[email protected]> wrote: > >If scientific (expensive) medicines can use the placebo effect > as the studies show, why would not the same pathways apply > to / be used by Ayurveda, homeopathy, alternative > medicines, nutraceuticals, etc.? >
I have no idea what the first part of the above question means. Any properly scientifically tested and validated medicine approved for ethical use, by definition, has to be more effective than a placebo, irrespective whether it is expensive or inexpensive. Alternative rituals that have not been tested for safety and efficacy in randomized placebo-controlled trials are by the same token of questionable utility. The term placebo effect is a misnomer. There is no specific and predictable "effect" of placebos. Which patient (or whether a patient) on a placebo would show improvement or not is totally uncertain and unpredictable. As I have stated before, placebo "effect" is a grab-bag term for statistical uncertainties about such as things as spontaneous recovery due to the self-limiting nature of many diseases, psychological components of illness, inaccuracy and imprecision in diagnosis, observer error, etc. A placebo is therefore a statistical control for these factors in the form of a sham or fake treatment such as a sugar pill that looks like the real thing. Therefore, if the second part of the above question asks why an alternative ritual cannot be treated as a placebo, then the answer is simple. The physician who prescribes a placebo to his patient is engaging in deception. He is intentionally lying to the latter that he is administering a real treatment with a predictable effect, when he clearly knows that he is not. The ethics of such deception are questionable outside the confines of a scientific clinical trial. The latter circumstance is exceptional because a legally and ethically valid informed consent is obtained from all participants of a study. > >What is intriguing, the various (3) types of > acupuncture (non-traditional treatments) had about twice > the benefit (60 percent) compared to the standard medical > care with anti-inflammatory drugs (39 percent). I > have still to study this paper in detail. > In fact, the conclusions of this study raise suspicions about the validity of acupuncture as a specific mode of treatment. Please see the following quote from the original paper: "Conclusions Although acupuncture was found effective for chronic low back pain, tailoring needling sites to each patient and penetration of the skin appear to be unimportant in eliciting therapeutic benefits. These findings raise questions about acupuncture's purported mechanisms of action. It remains unclear whether acupuncture or our simulated method of acupuncture provide physiologically important stimulation or represent placebo or nonspecific effects." Cheers, Santosh
