Reply #22: A placebo by any other name would smell as unethical

[Orrex]

I am not proposing "that we give the "alternative" practitioners license to use placebo..." They already have the right to use placebo, and they do.

They have the right to behave deliberately unethically? Maybe so, but they should include that fact in their advertisements. Instead, they gamble that their victims' desperation will keep the victims from probing the practitioners' methods too deeply. That's both predatory and unethical.

If it has been determined that a patient wants to get well and other treatments have failed...then I submit that it is unethical to withhold placebo. Placebo effect is real and powerful and is as effective as many pharmaceuticals. See post #10.

I've seen post #10 several times, as well as Trotsky's devastating reply to it. What's your point?

I had hoped to bring up this following point in its own thread, but this seems like a good place, since it directly refutes your falsehood that "Placebo effect is real and powerful and is as effective as many pharmaceuticals."

Placebo effect has never been shown to have any effect upon physical condition except in one of the two following cases:

1. The condition is entirely emotional/perceptual, such as stress or pain (accepting that pain is a neurological state that can be treated separately from the underlying injury or illness). In other words, the symptom is the condition being treated.

or

2. Healing of the condition is prevented by the persistence of a symptom described above. For example, an ulcer resulting from stress might be improved through use of a placebo that results in reduced stress, or illness that's prolonged by sleep deprivation might be improved if sleep can be induced through placebo.

Placebo has never cured an illness, never set a broken bone, and never repaired a torn muscle. If you cite a study showing that placebo did cure an illness, you must demonstrate that the statistical likelihood of this "healing" is greater than spontaneous remission or simple recovery (that is, recovery without medication, as from a cold).

We've all seen that episode of MASH where they ran out of morphine, and it's a lovely fairy tale that bears little resemblance to reality.

Next time you hit your thumb with a hammer, eat a sugar cube and tell yourself that it doesn't hurt. I'm sure that you'll be just peachy.

I am "requiring actual doctors to implicitly refer their patients" to no one. I'm simply suggesting that insurance would cover your choice of a menu of alternative treatments if you get an allopathic screening first, to rule out a more serious problem. This is a concept that you helped me develop, I surprised that you didn't recognize it.

I may need to retract my statement in that other thread. Upon further consideration, I realize that any screening system in which a doctor's visit sends a patient to an "alternative" "healer" is an endorsement of that "healer's" methods. And if the insurance carrier covers "alternative" practitioners, then that's an explicit endorsement of their non-verified methods.

How do you propose the "screening" might work, by the way? My doctor sees a shadow in my x-ray and says "You have tuberculosis and should check into the hospital," but instead I go to my acupuncturist. Why the hell should insurance cover that? Why shouldn't it cover the cost of having my house painted, which would be just as effective as acupuncture in curing my illness?

Where, exactly, do you draw the line between referral to "alternative" practitioners and referral to actual doctors?

If "a real doctor finds a tumor"..he should deal with it, not refer the patient out to alternative treatments

Really? Have you ever been to a doctor? My general practitioner isn't an oncologist, so I wouldn't want him to treat my tumor even if he's the one who found it.

NO! I'm saying that both systems have their problems and that allopathic harms and kills far more people than alternative. If you disagree please provide documentation.

Yet another red herring, as you're well aware--perhaps we'll start calling them "RedOnce Herrings" instead. Since the "alternative" "medicine" industry is unregulated, there is no statistical data to demonstrate how many have died in seeking "alternative" treatments. Instead, we have only the carefully selected positive endorsements of the industry, which is the very height of intellectual dishonesty.

Why don't you provide me with the documentation showing how many people have actually been cured by "alternative" "medicine?" Of course, personal testimony is insufficient--we'll need to see controlled, scientific studies demonstrating the efficacy of the "alternative" treatments.

What's that? There aren't any? Well, what a surprise.

Oh please, the profits of alternative medicine aren't even in the same ballpark as Big Pharma and Big Medicine. Not even close!

Relative to the demonstrated efficacy of actual medicine versus "alternative" "remedies," I'd say that the disparity is not nearly as great as you'd like to think. But that's hardly the point in any case--"alternative" practitioners are profiting from methods that have never been shown to work in controlled studies, but you somehow tolerate this because it's not quite as profitable as actual drugs that have been shown to be effective.

If you went after "alternative" practitioners with half the vigor you devote to your attacks on actual medicine, you'd decimate that quack industry in short order.