Homeopathy question.

[Borodog]

Homeopathy is bunk. If you buy into this stuff, you have serious mental problems and should stay out of my thread; I'm not buying what you're selling.

But given that the placebo effect is real, and placebos can hence be an effective treatment in some percentage of the population, just like any other treatment, isn't some sort of bunk like homeopathy the only way to actually sell placebos?

Let's say I know homeopathy is bunk (which I do). Normally I would say that selling something you know is ineffective is fraud. But since the placebo effect is real, are you doing something unethical in manufacturing and selling homeopathic "medications", since they are effective in some not insignificant percentage of users?

[bunny]

I think it's unethical since real medicine would work better. In other words there is benefit from the placebo effect regardless of what you sell - evidence based medicine has extra efficacy added in. By selling homeopathic "remedies" you will be persuading at least some people to not get treatment they would otherwise receive.

[Borodog]

[ QUOTE ]
I think it's unethical since real medicine would work better. In other words there is benefit from the placebo effect regardless of what you sell - evidence based medicine has extra efficacy added in. By selling homeopathic "remedies" you will be persuading at least some people to not get treatment they would otherwise receive.

[/ QUOTE ]

But real medications almost always have side effects, many of which can be very nasty. Wouldn't any sufferer who is sufficently helped by the placebo effect be better off taking sugar pills or denatured water rather than costly medicines with a laundry list of potential side effects?

PS. By the way, I'm not looking to defend a position, but establish one.

[chezlaw]

I don't think its unethical to sell a treatment that works to someone who wants to pay for the treatment in a manner that is necessary for the treatment to work.

Good post this. Not only have you come up with a case where it is good to lie to someone in a functional relationship but a case where it may be as good or even better to have a credulous moron providing the treatment.

chez

[bunny]

[ QUOTE ]
But real medications almost always have side effects, many of which can be very nasty. Wouldn't any sufferer who is sufficently helped by the placebo effect be better off taking sugar pills or denatured water rather than costly medicines with a laundry list of potential side effects?

[/ QUOTE ]
This is true if you can know who is going to get the side effects from the medicine and also respond to the placebo. Then you can restrict your sugar pills to them, while giving the rest the efficacious medicine. I think in most cases though, the cure is better than the side effect and therefore, when you make the decision, your chances are better with the real thing.

EDIT: In other words, I think you will be damaging more people (by depriving them of something better) than those you are helping (by giving them some relief rather than horrendous side effects)

[chezlaw]

[ QUOTE ]
I think in most cases though, the cure is better than the side effect and therefore, when you make the decision, your chances are better with the real thing.

[/ QUOTE ]
If we restrict to cases where the placebo works as well as the cure then this is not a problem. Most people taking headache pills or sleeping pills etc etc would be far better off with placebos. If you have a real disease then placebo's wont help much.

The problem is when you go to a a homeopothists with a something like an appendix problem and they aren't competent to diagnose it but as I guess the overwhelming majority of pills people take are either for problems that obviously require serious medicine or are for problem that have no underlying treatable cause, I doubt its that much of a problem.

chez

[Borodog]

[ QUOTE ]
[ QUOTE ]
But real medications almost always have side effects, many of which can be very nasty. Wouldn't any sufferer who is sufficently helped by the placebo effect be better off taking sugar pills or denatured water rather than costly medicines with a laundry list of potential side effects?

[/ QUOTE ]
This is true if you can know who is going to get the side effects from the medicine and also respond to the placebo. Then you can restrict your sugar pills to them, while giving the rest the efficacious medicine. I think in most cases though, the cure is better than the side effect and therefore, when you make the decision, your chances are better with the real thing.

EDIT: In other words, I think you will be damaging more people (by depriving them of something better) than those you are helping (by giving them some relief rather than horrendous side effects)

[/ QUOTE ]

How can you possibly know who will respond to placebo beforehand? /images/graemlins/confused.gif

[Borodog]

[ QUOTE ]
[ QUOTE ]
I think in most cases though, the cure is better than the side effect and therefore, when you make the decision, your chances are better with the real thing.

[/ QUOTE ]
If we restrict to cases where the placebo works as well as the cure then this is not a problem. Most people taking headache pills or sleeping pills etc etc would be far better off with placebos. If you have a real disease then placebo's wont help much.

The problem is when you go to a a homeopothists with a something like an appendix problem and they aren't competent to diagnose it but as I guess the overwhelming majority of pills people take are either for problems that obviously require serious medicine or are for problem that have no underlying treatable cause, I doubt its that much of a problem.

chez

[/ QUOTE ]

Yes, I should have made this clear. Please restrict the discussion to illnesses where use of placebo is known to be effective and not life-threatening because of substitution for real treatment (like headaches and not cancer, etc).

[bunny]

That's what I mean - you cant. That's why I think it is unethical to prescribe sugar pills. There are some people who are better off (those who were going to get side effects but who benefit from the placebo) but most people are worse off (because the net benefit of the medicine is greater than the placebo). The only way it would be defensible, in my opinion, would be if you could somehow target the two treatments to the two groups, which you cant, so you should follow the course with the greater net good.

[bunny]

[ QUOTE ]
[ QUOTE ]
[ QUOTE ]
I think in most cases though, the cure is better than the side effect and therefore, when you make the decision, your chances are better with the real thing.

[/ QUOTE ]
If we restrict to cases where the placebo works as well as the cure then this is not a problem. Most people taking headache pills or sleeping pills etc etc would be far better off with placebos. If you have a real disease then placebo's wont help much.

The problem is when you go to a a homeopothists with a something like an appendix problem and they aren't competent to diagnose it but as I guess the overwhelming majority of pills people take are either for problems that obviously require serious medicine or are for problem that have no underlying treatable cause, I doubt its that much of a problem.

chez

[/ QUOTE ]

Yes, I should have made this clear. Please restrict the discussion to illnesses where use of placebo is known to be effective and not life-threatening because of substitution for real treatment (like headaches and not cancer, etc).

[/ QUOTE ]
OK - I guess I'm talking cross purposes (although I dont think headache treatments have a laundry list of side effects and high costs).

If the placebo is as good or better than the treatment, then it is ethical imo (and right to conceal the sugar-pill nature of the treatment if that is necessary to the placebo effect working).

[Borodog]

[ QUOTE ]
That's what I mean - you cant. That's why I think it is unethical to prescribe sugar pills. There are some people who are better off (those who were going to get side effects but who benefit from the placebo) but most people are worse off (because the net benefit of the medicine is greater than the placebo). The only way it would be defensible, in my opinion, would be if you could somehow target the two treatments to the two groups, which you cant, so you should follow the course with the greater net good.

[/ QUOTE ]

This doesn't make sense. Shouldn't you try the simplest treatment with the least chance of side effects first, and then escalate from there?

I.e., shouldn't a doctor's first option always be placebo if it is known to be effective?

Besides, I'm not talking about doctor's prescriptions, but over-the-counter sales and self-administration.

[carlo]

Doubt that you will find any physicians in the USA who have ever prescribed a placebo. There are tales of physicians in the early half of the 20th century who would prescribe as such and the pharmicist(before he became a pill counter) would dispense or even manufacture.

Homeopathic prescribing,from what I've heard, is more prevalent in Europe and to some extent throughout the world. It has its place but doesn't lend itself readily to the materialistic notion of medicine.

I'd like to hear from our British cousins on this matter for I know there are schools in Great Britain.

[bunny]

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Besides, I'm not talking about doctor's prescriptions, but over-the-counter sales and self-administration.

[/ QUOTE ]
I get where you are coming from now - I misunderstood the thrust of your post and thought it was the "Crystals-or-chemotherapy" decision we were talking about (where delay can do lots of damage).

[Borodog]

np

[John21]

[ QUOTE ]
Let's say I know homeopathy is bunk (which I do). Normally I would say that selling something you know is ineffective is fraud. But since the placebo effect is real, are you doing something unethical in manufacturing and selling homeopathic "medications", since they are effective in some not insignificant percentage of users?


[/ QUOTE ]

As far as business ethics go, I prescribe to the physician's motto: first, do no harm. After that it's pretty much fair game. I figure in business, my purpose is to give people what they want, not what I think they should want. Of course it's nice if you actually do some good, but who's to decide what that is - you or them?

[Borodog]

Excellent post.

[chezlaw]

[ QUOTE ]
OK - I guess I'm talking cross purposes (although I dont think headache treatments have a laundry list of side effects and high costs).

[/ QUOTE ]
Headaches are at the minor end but all pain relief is nothing to do with treating any physical problem, its just dealing with one of the symptoms or dealing with a mental problem like stress or anxiety. Addiction to painkillers is a major problem and it would be much better if people became addicted to some fancy labelled water.

Insomnia might be a better example. Some people (me included at times) can't sleep because they are anxious about getting to sleep. A placebo that could deal with this must be far better than potentially addictive sleeping pills.

chez

[bunny]

[ QUOTE ]
[ QUOTE ]
OK - I guess I'm talking cross purposes (although I dont think headache treatments have a laundry list of side effects and high costs).

[/ QUOTE ]
Headaches are at the minor end but all pain relief is nothing to do with treating any physical problem, its just dealing with one of the symptoms or dealing with a mental problem like stress or anxiety. Addiction to painkillers is a major problem and it would be much better if people became addicted to some fancy labelled water.

Insomnia might be a better example. Some people (me included at times) can't sleep because they are anxious about getting to sleep. A placebo that could deal with this must be far better than potentially addictive sleeping pills.

chez

[/ QUOTE ]
Yeah - I just went along the wrong path. I was considering the situation at the crystal healing vs chemotherapy end of things. I agree with you at the scale you are talking.

[Phil153]

[ QUOTE ]
But since the placebo effect is real

[/ QUOTE ]
This is debatable. It's also a matter of degree.

[ QUOTE ]
are you doing something unethical in manufacturing and selling homeopathic "medications", since they are effective in some not insignificant percentage of users?

[/ QUOTE ]
You're only doing something unethical if you claim your product works on certain ailments, or has a specific mechanism for improving health. Simply providing a legal product that people want to buy is not unethical if you don't misrepresent it (either by statement or omission).

[ALawPoker]

[ QUOTE ]
As far as business ethics go, I prescribe to the physician's motto: first, do no harm. After that it's pretty much fair game. I figure in business, my purpose is to give people what they want, not what I think they should want. Of course it's nice if you actually do some good, but who's to decide what that is - you or them?

[/ QUOTE ]

Agree with this.

I don't consider it fraud when I sell a squirt gun with super cool packaging, and market it with awesome commercials that allude to the fact that the squirt gun is special, and makes every kid beg their parents to buy it for them, even though my squirt gun is just a dinky little thing that I know most kids won't play with more than twice. As long as I don't ever lie about what exact contents are in the package, it doesn't matter how I pitch it. Maybe some kids will be so enamored by my pitch that they'll convince themselves they like it. Maybe some parents with a kinky mind will find a use of their own from my toy.

I see the placebo medicine as the same fundamental issue. It is not fraud unless I make a faulty claim into the chemical and biological functionality of the pill. I could call it "Magic Potion" and as long as I didn't lie about what exactly "Magic Potion" consisted of, I don't see this as fraud. It is not my job to figure out exactly what my buyer wants the product to do for them.

On that note though, I guess I disagree with Boro's suggestion that the sale of the product would be fraud in the absence of a placebo effect. Maybe some people see my product as a rare collector's item that they will store and try to sell on ebay in 20 years! As long as I don't lie about what physical contents I am selling, I don't think it's fraud. I don't think it's my ethical responsibility as a provider to guarantee performance or customer satisfaction -- it is the market's job to stop buying my product if they are not getting what they want from it.

[PLOlover]

Depends what you mean by homeopathy. If you mean some kind of extract that is watered down to 99.99999% pure water then I think everyone agrees with you that it is just and only a placebo.

But if you mean natural herbal remedies then I think you are dead wrong. A lot of them really work, I was completely surprised.

I have personal experience with valerian root, which let me tell you, it pretty much puts you to sleep, it zonks you out.

True, the effects of herbs are subtler than drugs and generally speaking I think they are part of a lifestyle change, not a magic bullet.

[DougShrapnel]

Good question Boro, I can't say I know if I want to take either side of this question. Could you possibly clear something up for me? What are the most likely reasons for a placebo to work?

[David Sklansky]

"Good post this. Not only have you come up with a case where it is good to lie to someone in a functional relationship but a case where it may be as good or even better to have a credulous moron providing the treatment."

chez

COME UP WITH? Poker Gaming and Life. Page 187.

[vhawk01]

[ QUOTE ]
[ QUOTE ]
OK - I guess I'm talking cross purposes (although I dont think headache treatments have a laundry list of side effects and high costs).

[/ QUOTE ]
Headaches are at the minor end but all pain relief is nothing to do with treating any physical problem, its just dealing with one of the symptoms or dealing with a mental problem like stress or anxiety. Addiction to painkillers is a major problem and it would be much better if people became addicted to some fancy labelled water.

Insomnia might be a better example. Some people (me included at times) can't sleep because they are anxious about getting to sleep. A placebo that could deal with this must be far better than potentially addictive sleeping pills.

chez

[/ QUOTE ]

That is definitely not what all pain medication or pain treatment is about.

EDIT: Sorry chez, I missed an 'or' in there, I retract my statement.

[chezlaw]

[ QUOTE ]
"Good post this. Not only have you come up with a case where it is good to lie to someone in a functional relationship but a case where it may be as good or even better to have a credulous moron providing the treatment."

chez

COME UP WITH? Poker Gaming and Life. Page 187.

[/ QUOTE ]
nice try but I'm not buying that book /images/graemlins/wink.gif

chez

[Borodog]

[ QUOTE ]
"Good post this. Not only have you come up with a case where it is good to lie to someone in a functional relationship but a case where it may be as good or even better to have a credulous moron providing the treatment."

chez

COME UP WITH? Poker Gaming and Life. Page 187.

[/ QUOTE ]

For the record, this is one of the few of your books that I have not read.

[Borodog]

[ QUOTE ]
Depends what you mean by homeopathy . . .

[/ QUOTE ]

By homeopathy I mean homeopathy, where some substance that causes the symptom one is trying to treat is diluted far beyond the point where there is even a single molecule of the stuff left in the product, and where there is no plausible mechanism by which any such "treatment" could possibly work, beyond the power of the human mind to believe that it will work.

[PLOlover]

[ QUOTE ]
By homeopathy I mean homeopathy, where some substance that causes the symptom one is trying to treat is diluted far beyond the point where there is even a single molecule of the stuff left in the product, and where there is no plausible mechanism by which any such "treatment" could possibly work, beyond the power of the human mind to believe that it will work.

[/ QUOTE ]

Yeah I don't get that either. I guess I was thinking of naturopath or something. but obviously pure water will only cure thirst lol.