07-26-2021, 09:13 AM
(07-26-2021, 08:03 AM)jamincan Wrote: The reality is that placebo is a very powerful effect and that people can derive very real benefits from it. While I largely agree with skeptic groups like Science-based Medicine, I think it is a mistake to dismiss treatments that are shown to have no effect beyond placebo as quackery, when patients are shown to derive a benefit, sometimes powerful, regardless. They would argue that on the whole, accepting that "quackery" is harmful to society, outweighing the placebo benefit, but that is largely a doctrine within these groups with, ironically, very little scientific basis.
They tend to also to have blinders when it comes to western medicine's shortcomings. Surgical treatments, for example, have had almost no clinical trials to establish their effectiveness (for pretty clear reasons). The one notable instance where they did a study looking at patients treating osteoarthritis in the knee with arthroscopic surgery, comparing them to a placebo group that underwent the same surgery, but without the actual treatment being completed, found no difference between the groups. Yet, this surgery continues to be performed by the thousands.
No question that the placebo effect is real and has real health impacts. That, I think, is why things like acupuncture are recognized as treatments by the WHO.
But I think it is still important to recognize that they are a placebo and not actually having a direct therapeutic effect. What to do with that knowledge is both a personal question, and a context sensitive broader social question.
On the other tangent...I am really quite shocked that any ethics board would approve surgical clinical trial with a non-treatment control group. Without seeing the study, I don't know, but I assume the trial was between two different surgeries, and possibly not entirely blind. Not the most rigorous study but still a good datapoint.
Surgeries are generally considered to be beneficial without the same blind, controlled, clinical trials for...lets call it heuristic reasons. First, a surgery causes significant harm to the individual, so any benefits derived must outweigh that initial harm. And second, at least in theory, a surgery is physically correcting some defect. Therefore, it is not unreasonable to assume that any positive outcomes as a result of surgery are more likely to be the result of surgery than of placebo. But as we do learn more about both the power of placebo effect and also the importance of how we measure outcomes, that does become more clouded on some more...optional...surgeries. I mean, are numerous types of surgeries confined to the annals of history at this point--this is hardly new.
There are limits of western medicine, our biases being only part of it, and while I believe the scientific method is sound, it should not be our ONLY measure of utility.