Homeopathy as ethical placebo?

Sitric

Hi, I´ve been laughing my ass off for the last two days reading Ben Goldacre´s Bad Science.

I was wondering about something though,

Could you ethically reconcile prescribing a homeopathic remedy as a placebo in a case where you feel a placebo might just help?

anotherlostie

I think a lot of people would be of the opinion that homeopathic remedies already work on the basis of a placebo effect. But as I don't know of any sugar pills that could be dispensed as placebo, I suppose homeopathic remedies would be the most available thing.

JuliusCaesar

As a placebo is inert, its only functioning is psychological.........

Sitric

Of course, I agree completely.

However, just because it's psychological doesn't mean it has no effect. I think the prescription of placebo can have profound effects, i'm just wondering if it's ethically or morally justifiable. If you know it is inert (sugar pill, serial dilution, whatever) can you give it to a patient in good conscience without telling them this fact?

The reason I was thinking about homeopathic preparations is if they are made correctly. the way homeopathic theory says they should be, they have no active ingredients so they are safe to give to anyone (well maybe not diabetics). Further, you don't have to just give someone a salt water injection or sugar pill while pretending it is something active.

JuliusCaesar

You're not necessarily pretending the placebo is something else. If you sign up for an RCT, you'll be told that you'll be randomised into either the control (placebo) group OR the intervention group, but that neither you nor your prescribing doctor will know which group you are in.

Hmm, wonders if there's been an RCT of homeopathy using water as the 'placebo'? eh, water that has never ...I mean, eh, plain tap water that's never been diluted with more water, eh, .....

Sitric

I take your point but i'm really wondering about how you can tap into the possible benefits of the placebo effect in normal practice not in a trial. In a case where a pharmacological intervention would not be appropriate but somebody may benefit from a 'sugar pill'

I don't believe you can give someone a sugar pill and tell them it is something other than it is.

And though I could be wrong, I thought most trials now compare the treatment being investigated against the best available treatment already in practice, not against placebo?

It doesn't really matter if something is better than placebo, more that it's better than whatever you have. Apart from the fact that withholding effective treatment is another ethical question altogether.

Sitric

Hmm, wonders if there's been an RCT of homeopathy using water as the 'placebo'? eh, water that has never ...I mean, eh, plain tap water that's never been diluted with more water, eh, .....[/QUOTE]

Or at least water that doesn't remember it's ever been diluted!

JuliusCaesar

Yeah you're right, it's often against TAU - Treatment As Usual. Or in psychology, waiting list controls.

Tree

afaik, a doctor can't "prescribe" a placebo, as this means they're in effect lying to the patient (even if it's for the good of their health). Joining a RCT, you've signed up for the possiblilty of a placebo though, so you are informed and not being misled as such.

Ihaveanopinion

Strictly speaking, if you are doing a study into a treatment and you want to use a homeopathic treatment as a comparison, its not a placebo.

A placebo implies that there is no physiological affect as previously mentioned. Even if the homeopathic treatment is diluted to bejesus, there is still (at least the possibility of ) some drug in the dose.

Therefore you are comparing two treatments and not a treatment versus a placebo.

There are so few and poorly designed studies into homeopathic remedies that the effect isnt known really

grrrrrrrrrr

thing about homoepathy on gerry ryan now!

Dave!

What did they say, grrrrrrr ?

It's interesting that this thread was bumped, because recently I've been considering the issue also. Obviously homeopathy is just placebo, but the placebo effect really does work quite well in some circumstances, so I'm kind of torn. Is there ailments for which doctors generally prescribe 'sugar pills', or is it just not done?

Obviously conventional medicine should be first choice, but where there's evidence to suggest that a placebo may help, then surely it's justified to supplement the real medicine with a placebo of some sort?

grrrrrrrrrr

Dave! wrote: »

What did they say, grrrrrrr ?

It's interesting that this thread was bumped, because recently I've been considering the issue also. Obviously homeopathy is just placebo, but the placebo effect really does work quite well in some circumstances, so I'm kind of torn. Is there ailments for which doctors generally prescribe 'sugar pills', or is it just not done?

Obviously conventional medicine should be first choice, but where there's evidence to suggest that a placebo may help, then surely it's justified to supplement the real medicine with a placebo of some sort?

DAVE!, gerry ryan said he'd never promote it because a couple of years ago he said there must be some good in it and to keep an open mind but a day later a woman rang him to say her own mother stopped getting chemo for breeast cancer cause she believed gerry ryan and wanted to try it out!! he was very upset about that!!

listen to it on the rte site http://2fm.rte.ie/show/11



dono did ye hear the things in boots a few weeks ago where protesters over dosed on the homoepathy stuff and nothing happened!!!

grrrrrrrrrr

might interest you!





dono can i do this so put link below!

https://www.youtube.com/watch?v=VIaV8swc-fo

http://www.youtube.com/watch?v=VIaV8swc-fo

Pete4779

https://www.youtube.com/watch?v=HMGIbOGu8q0

grrrrrrrrrr

Pete4779 wrote: »

eh mate its blank! think this is wat u want

https://www.youtube.com/watch?v=HMGIbOGu8q0

Sitric

This one is amazing, lunatic stuff

http://www.youtube.com/watch?v=C0c5yClip4o

Dave, that's pretty much what I was wondering, there are times when a placebo can help, and a recent survey i think by the AMA (but i'll have to check) showed that while it has been deemed unethical to prescribe something that has no pharmacological effect, many doctors admitted to using a placebo in the last yr.

I guess to use homeopathy you just have to pretend you believe it works

Or say, many people find tincture of blah blah blah helpful....

grrrrrrrrrr

Sitric wrote: »

This one is amazing, lunatic stuff

http://www.youtube.com/watch?v=C0c5yClip4o

Dave, that's pretty much what I was wondering, there are times when a placebo can help, and a recent survey i think by the AMA (but i'll have to check) showed that while it has been deemed unethical to prescribe something that has no pharmacological effect, many doctors admitted to using a placebo in the last yr.

I guess to use homeopathy you just have to pretend you believe it works

Or say, many people find tincture of blah blah blah helpful....

well some people have nothing wrong wit them anyway except their brains!!

and would it not be worse if they were prescribing antibiotics and creating some very resistant bacteria??

btw im against homeopathy