In a dry, but interesting reframing of the role of placebo in healing and in research from the Journal of the Royal Society of Medicine the authors assert that the placebo effect can be observed independently of a doctor's direct efforts. Placebo regimens are used in a couple of ways. In one a relatively neutral agent is used to provoke the patient into self-healing. It happens all the time. Doctors have even begun proscribing placebo for parents to use with children.
In another, placebos are used in randomized, double-blind trials (researcher and subject are unaware of which is the drug and which is the placebo). If 40% of group A improves on the drug and 30% of group B improves on the placebo, the effectiveness of the drug is considered to be 10%.
This is a big assumption, but there it is. In psychiatric drug trials, for instance, drug companies use a "placebo washout" to ensure that their drug fares better than placebo. It goes like this: a group of 100 join the trial, say they all suffer from significant anxiety problems. All are given a placebo. 40 get better. Those 40 are removed from the trial. 60 remain. The 60 are divided into two groups, A and B. One is given the drug, one is given placebo. If the drug group fares better that the placebo group the findings are reported as evidence of drug effectiveness (over placebo).
But of course, a huge chunk of people were removed to try to ensure exactly that outcome.
Nevertheless, this is standard practice.
The assumption is that the placebo is "noise" in the study. The authors suggest that not only is the placebo a potentially powerful agent for healing, but that the healing is not just a response to the clinician's care and attention.
The idea is that our bodies are deeply conditioned to healing interventions. For instance, heroin addicts have been noted to get withdrawal relief merely by injecting water into their veins. KNOWINGLY. Deception is not necessary to evoke a healing effect.
The reframing is "Contextual Healing", that the whole context of providing care provides opportunity for healing- from the mechanics of delivery, to clinician's care, to the drug agents themselves.
Some part of each of us is fundamentally healthy. We respond to healing in a multitude of ways.
In another, placebos are used in randomized, double-blind trials (researcher and subject are unaware of which is the drug and which is the placebo). If 40% of group A improves on the drug and 30% of group B improves on the placebo, the effectiveness of the drug is considered to be 10%.
This is a big assumption, but there it is. In psychiatric drug trials, for instance, drug companies use a "placebo washout" to ensure that their drug fares better than placebo. It goes like this: a group of 100 join the trial, say they all suffer from significant anxiety problems. All are given a placebo. 40 get better. Those 40 are removed from the trial. 60 remain. The 60 are divided into two groups, A and B. One is given the drug, one is given placebo. If the drug group fares better that the placebo group the findings are reported as evidence of drug effectiveness (over placebo).
But of course, a huge chunk of people were removed to try to ensure exactly that outcome.
Nevertheless, this is standard practice.
The assumption is that the placebo is "noise" in the study. The authors suggest that not only is the placebo a potentially powerful agent for healing, but that the healing is not just a response to the clinician's care and attention.
The idea is that our bodies are deeply conditioned to healing interventions. For instance, heroin addicts have been noted to get withdrawal relief merely by injecting water into their veins. KNOWINGLY. Deception is not necessary to evoke a healing effect.
The reframing is "Contextual Healing", that the whole context of providing care provides opportunity for healing- from the mechanics of delivery, to clinician's care, to the drug agents themselves.
Some part of each of us is fundamentally healthy. We respond to healing in a multitude of ways.
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