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On Sat, Dec 19, 2009 at 08:48:24PM +0000, Simon Waters wrote: > The article also raises the doctor/patient relationship issue. How would > you react if you discovered your doctor was palming you off with sugar > pills? Would you doubt any future pills? > > Cost is one question, but also does the provider of said remedies push > some nonsensical ideas with it, and will folks come back to those ideas > when they have something else or something more serious wrong with them? > The case of Thomas Sam springs to mind, a result of creating a culture > based on ineffective remedies and opposing scientific medicine. > I think the situation is worse. 1/ Placebo's work in some cases. 2/ One factor is making in making placebos work appears to be belief that it will work 3/ One factor that makes people believe that something is effective is if it is a) is sold by a professional, b) expensive (eg see Veblen goods) or eg http://theglitteringeye.com/?p=9315 Question Should a well trained professional offer something that should not work, if in a minority of cases it will; especially if the diagnosis of the illness takes time and resources that are in short supply and may well result in another person not receiving treatment that will work? > A corollary of the "it is rare..." sentiment, is that many drug trials > are now against the current drug of choice for a disorder, rather than > against a placebo. Since it doesn't matter if a treatment works if it > doesn't offer any benefits over existing treatments. > From a logical point of view this makes a lot of sense and is followed or driven by NICE (National Institute for Health and Clinical Excellence). I believe their remit is to effectively rank treatments by cost-effectiveness per quality adjusted life year. IF however you are ill (eg terminal cancer), and there is nothing that will improve your health; how much would you pay for a placebo wrapped up in scientific language? And finally should someone be allowed to sell you a placebo that might work but has no proven ability to work? -- Henry Photocopies or faxes of my signature are not binding. This email has been signed with an electronic signature in accordance with subsection 7(3) of the Electronic Communications Act 2000. Digital Key Signature: GPG RSA 0xFB447AA1 Sun Dec 20 10:54:46 GMT 2009
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