Feb 09 2007

Placebo Effect Not So Harmless

In response to my chiropractic entry there was a response essentially commenting that if it provides a placebo effect and people feel better, what’s the big deal. My prior entry on the placebo effect is a good place to start, but I will add a few more observations.

Although a placebo effect is of limited use, and not sufficient to justify anti-scientific treatments, let alone deception and fraud, it can also have negative consequences, and should not be viewed as benign. The primary malignant effect is that a placebo effect can seem very compelling evidence that a treatment works – meaning that it has a physiological effect. This can lead to the false conclusion that the theory behind a modality is valid, and therefore all of the claims for that modality are valid, or at least should be taken seriously.

The direct harm from this misleading aspect of the placebo effect is that it will cause people to rely upon worthless treatment when they become seriously ill. So if that homeopathic remedy made your headache better, why not take it for your malaria or even AIDS or cancer. This is a very genuine problem.

The second effect, someone less direct, is that it leads to the promotion of unscientific and aberrant views of health and disease. This supports an infrastructure of pseudoscience in the medical field, draining away precious limited resources from more valid treatment, and distracting patients away from effective interventions. It blurrs the line between science and pseudoscience. If people think they can cure their asthma by adjusting their spine, then they will become very confused about how the body truly functions. They will also not know who to trust – one person in a white coat is telling them that sugar pills without any active ingredient can have healing powers, and another person in a white coat is telling them this is utter nonsense. So respect for the institution of science is diminished, authority is diluted, and the public is left in relative confusion.

Admittedly, the placebo effect is only one piece of this insidious picture  – but it is a critical piece, because it is what most often convinces people that nonsense can work, and that therefore the scientist don’t really know what they are talking about.

So don’t for a second think that nonsense, especially in the field of medicine, is harmless.

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