Placebo therapy is fraud

I’ve often had discussions with friends and patients that go something like:

Friend/relative/patient: “I went to [blah blah] alternative therapy the other day.  I feel great.  You should recommend [blah blah] alternative therapy to all your patients.”
Me: “But [blah blah] natural therapy is a sham.  There’s no good quality evidence to prove that it’s better than a placebo.”
Friend/relative/patient: “But I feel better, and so does Jo Bloggs who lives two doors down.  She said it cured her bad back that she’s had for twenty years.”
Me: “Well, that’s great for Jo Bloggs.  It still doesn’t mean that it’s any better than a placebo.”
Friend/relative/patient: “I don’t care whether there is any evidence for [blah blah] alternative therapy.  I feel better.  That’s all the evidence that I need.”

As they walk away from this conversation, most people think I’m an arrogant unsympathetic retard because I didn’t gush with enthusiasm for their miracle cure.  I’m not unhappy for them.  But placebo therapy is a pet hate of mine that tends to overshadow any deeper joy.

A placebo is any medical treatment that is inert or inactive.  Around one third of people who take placebos will experience an end to their symptoms. This is called the placebo effect.

Placebo therapy is my own description for any treatment which is marketed as having amazing healing properties, but in reality, the only healing it provides is through the placebo effect.  To me, profiting from such therapies is tantamount to fraud.

Some would disagree.  After all, the pillars of medical ethics are, “First, do no harm” and, “Do good.”  If the therapy they offer does no harm, and does some good, then what’s the problem?  The end goal was to make the patient feel better, and if they do, what does it matter that it was the treatment or the placebo effect?

Here’s a hypothetical.  Imagine if I go into a hardware store and ask for a hammer so that I can make some minor repairs to my house.  The store only had baseball-sized rocks, and sold one to me.  I could use the rock to knock out some walls, nail some bits of wood together.  It just so happened to help me.  But it isn’t a hammer.  It’s barely even a tool.  To sell it as a tool or specifically a hammer would still be fraud, despite the eventual outcome.

What if a drug company were to market a sugar pill, claiming a medicinal benefit.  The placebo effect would guarantee that one third of the people who used it would feel better for it, but it would still be fraud.  Our community would be outraged.  Imagine the scathing media reports and the indignation from political and community leaders.  There would be calls for jail time for the executives who profited by misleading the public, and rightly so.

The market for herbal supplements in Australia alone is worth billions of dollars.  Yet there is a paucity of rigorous scientific trials of these herbs.  I could count on one hand the number of herbs that have evidence that they’re better than a placebo.  The other thousand or so unproven herbal supplements are no better than mass-marketed sugar pills.

Any herb, supplement or other treatment needs to show that it has a better outcome than a placebo before it can claim to be therapeutic.  To claim otherwise is fraudulent, and even though I may seem like an arrogant unsympathetic retard, I think people deserve better than being mislead by claims that can not be fully substantiated.

More information on the placebo effect can be found here – http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Placebo_effect?open

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2 Responses to Placebo therapy is fraud

  1. I agree that a treatment needs to show more effect than a placebo in order for it to be seen as effective. However, another hypothetical: how much influence do you think the power of thought has on our life? Would it be possible to restore our sense of happiness and wellbeing just by observing what thoughts we hold? Or is thought just yet another placebo?
    Do things always have to be fully substantiated before anyone is allowed to experience the outcome? We will never find the miracle cure if nobody ever tries it out first.
    Great article by the way!
    Sometimes arrogant unsympathetic retards are rather refreshing 😉
    Love
    Anna

    • Thanks for your feedback! In regards to your hypothetical, I think it is indeed possible to restore happiness and wellbeing by focusing on our thoughts. Cognitive Behavioural Therapy, and Acceptance and Commitment Therapy are two psychological therapies that at their most fundamental, are simply methods of recognising maladaptive thought patterns and learning to replace them with constructive ones. As for the question of whether thought is another placebo, I think a placebo is a tangible object or action which triggers the power of the subconscious human brain. Of course, not everyone experiences a placebo effect with each placebo they are given. And the strength of the placebo effect is limited. There is certainly a lot more to be discovered about the placebo effect. But it does demonstrate that there is more to us than the pure physical, and our psyche and our spirituality have a bigger place in our wellbeing than western medicine has traditionally acknowledged.

      As to your question about whether things need to be fully substantiated before anyone can experience the outcome, well, of course the answer is, “no”. There are many drugs and treatments which are known to work beyond the placebo effect, but it is not known how exactly they work. I think that the first rule of medical ethics holds sway here, “First, do no harm.” The treatment needs to be shown that it is safe, and it should also be shown to be effective (more than a placebo). Once that is established, it is safe to say that patients won’t be maimed or defrauded, and the public should be free to use the treatment. If more needs to be known about the treatment, then more research can be done, while people are also safe to enjoy the benefits of the treatment.

      Anyway, thanks for your feedback. I hope you enjoy my future, sporadic postings.

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