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Proposal Outline

Proposal Blog

Peer Tags: don't forget that each group member must provide some wiki trace (a brief rhetorical analysis or a description of an appeal/strategy that emerged in a close reading of your sources) of the "audience finding" process -ShareRiff

Grant for Proposal

Proposal Summary

Proposal   Summary PDF Version

Permission to Conduct Research

Research Study in Florida

Unit 4 Final Presentation

Mission Statement

We will focus all our energy to inform and educate people and provide an overview on how placebos and placebo effects impact on clinical practice. Our goal is to promote knowledge and benefits of this healing science wherever the human race exists and the suffering prevails.

Thesis Statement

A common argument against placebo is that its use is unnecessary, and therefore unethical, when “proven effective therapy” exists!

Rather than figuring placebo as deception, we advance the hypothesis that placebo can empower patients, and trigger self-healing.

To achieve a better understanding of the phenomenology of placebo effects in therapeutic relationships, we will like to highlight some of the ethical, legal, social, and scientific issues that such treatment raises.

Introduction

The concept of a placebo effect, by which patients get better from the mere illusion of treatment has been a hot topic for debate for a long time. The phenomenon is not fully understood by science, but there has been clinical evidence of its presence. Research shows that the placebo effect can be greater and is far more ubiquitous than commonly thought.

Placebo meaning an inert treatment, given as if it was a real treatment, means lots of different things to different people. By examining different aspects of the placebo effect, we can formally show how effective the placebo effect can be, and therefore, deem it ethical or unethical.

What is Placebo Effect ? How can it be explained?

Also Known As: Placebo, Placebo response, Power of suggestion. The word placebo literally means “I will please” in Latin. A placebo is an inactive substance that has no treatment value. The placebo effect is the measurable, observable, or felt improvement in health not attributable to an actual treatment.(1) It seems that it is the result of the patient's expectation of an effect.

According to Wikipedia, Placebo effect is the term applied by medical science to the therapeutical and healing effects of inert medicines and/or ritualistic or faith healing manipulations. When referring to medicines, placebo is a preparation which is pharmacologically inert but which may have a therapeutical effect based solely on the power of suggestion.

In simple terms, placebos have been a fake treatment, an inactive substance like sugar, distilled water, or saline solution given to people in place of real medications. The placebo effect also called placebo response occurs when a patient believes they are improving because they know they are receiving medical treatment, though no true improvement in symptoms occurs. The placebo effect is triggered by the person's belief in the treatment and their expectation of feeling better, rather than the specific form the placebo takes.

Types of Placebo

Placebos takes many forms : It can be inert (devoid of any action)such as a sugar pill,or active,(that actually have actions) orally consumed substance (sometimes termed a dummy), a procedure or a situation.

What Causes the Placebo Effect?

Medical Science has not been able to answer as yet what causes the Placebo effect. It is believed that it is the patient’s expectation from the treatment rather than from the treatment itself.

It is believed that the placebo effect is psychological, due to a delusion on the part of the subject that the treatment will work. The patient's beliefs and expectations seem to have a significant biochemical effect or you can say it may invoke a "conditioned response" as studied by Ivan Pavlov.We are conditioned to believe that medicine makes us better when we're ill, so any treatment that we receive may make us psychologically confirm this belief.(2) The empathy, encouragement and support given by the care provider also constitute this psychological belief.

The patient think they are feeling better, but is it real or the placebo effect? Let’s look at some of the examples:

One patient stands out in the memory of Stephen Straus, M.D., for her remarkable recovery, more than 10 years ago, from chronic fatigue syndrome. The woman, then in her 30s, was "very significantly impaired," says Straus, chief of the Laboratory of Clinical Investigation at the National Institute of Allergy and Infectious Diseases. "She had no energy, couldn't work, and spent most of her time at home." But her strength was restored during a study to test the effectiveness of an experimental chronic fatigue drug. Like many drug studies, the chronic fatigue medication trial was a "placebo-controlled" study, meaning that a portion of the patients took the experimental drug, while others took look-alike pills with no active ingredient, with neither researchers nor patients knowing which patients were getting which. She and her parents were so thrilled with her recovery that they were blessing Stephen Straus and his colleagues.(3)

Just recently one of my peer Amber participated in a sleep study. Everyone who participated in the study was unknowingly divided into two main groups. The group she was in took placebo pills or sugar pills. The other group took the drug being tested. She took the pill for two weeks and was amazed at how much better she was sleeping at night. Little did she know that her pill was a fraud!(4)

As narrated by Eddy Savary “Some years ago, a patient came to me, suffering with violent abdominal pain and jaundice. Thinking it was biliary calculus, I immediately took her into surgery, but on the operating table we discovered a big malignant tumor which already had invaded the whole liver and metastases were covering almost all the abdominal wall. Thinking the case hopeless, the surgeons decided to close up without attempting anything. Her daughter, very insistent, begged for me to say nothing. So, I just told the patient that the biliary calculus was successfully removed...Eight months later, to my great surprise; this woman came again to see me. The medical examination no longer revealed any jaundice or pain or cancer sign anymore. She then told me this amazing thing: ”I was so sure to have a cancer, when I knew it was just biliary calculus, I promised to myself not to be ill in my life anymore.” Here the placebo effect was to stifle the cancer and to make her believe that the operation really took place.(5)

A study in England was done where 100 men were told that they were taking chemotherapy, when in actuality they were taking inactive saline solution. 20% of these men lost their hair, demonstrating the power of the belief of effects of the treatment.

Now we have established the fact that Placebos do work, now let's talk about their positive and negative effects.

Positive Effects

Placebos may lack actual chemical functioning, but it has been documented that 30-40% of patients experience the positive effects of placebo.

Placebos have been known to treat angina pectoris, hypertension, gastrointestinal disorders, reflux oesophagitis, asthma, allergies, flu symptoms, sleep disorders, sea sickness, and nocturnal enuresis (Weihrauch, Gauler, 1999). Treating pain and affective disorders such as depression, bipolar disorder, mania, and anxiety disorders are areas where placebos seem to have the greatest effect.

One of the positive effects of placebo is the effect of expectation. People who expect to get better have a better chance of actually getting better than those who don't.

Negative Effects

It should also be noted that the effects of Placebo are not always positive.Placebos in many patients have been linked to side effects, some of which are severe fainting spells and cardiac dysfunction (Wiehrauch, Gauler,1999).

Some consider that the cures due to the placebo effect perpetuate the use of ineffective and irrational medicinal therapeutic procedures, as those used in the so-called "alternative medicine".

Why people use alternative medicine?

Alternative medicine is used by many people. People like to use alternative medicine because of various reasons. Conventional medicine is not always perfect and it can have many side effects. In regards to that, a lot of people don’t trust conventional medicine and instead use alternative medicine. Another likely reason why people might want to use alternative medicine is because it matches their culture or beliefs. Many people hold new-age ideas and philosophies. They believe that alternative medicine is more of a natural kind of healing and believe that everything “natural” is somehow better for us.

Is prescribing placebos ethical or unethical?

Prescribing placebos can either be ethical or unethical.

It can be considered ethical because it actually makes the patient think that it’s helpful. Patients are led into believing that the healing process has started and they automatically develop a healthier or happier feeling which ultimately causes the patient to truly feel that way. It is a very effective mind-game that certainly could help many people get over certain sickness or feelings. At the same time, placebos do not contain any ingredients that could possibly cause any side-effects, unlike real prescription. Another reason why prescribing placebos can be ethical is because not only does it make the patient think mentally that it helps, but also because doctors can use these treatments to study the human mind and its effectiveness. Prescribing placebos can help doctors and scientists learn more about the human mind and use it. However, prescribing placebos can also be unethical in life-threatening or serious situations.

Conclusion

Sometimes we no longer know what is true for us, in which direction our own integrity lies; coming to recognize and accept that we have in us both sides of everything. We are capable of fear and courage, generosity and selfishness, vulnerability and strength. These things do not cancel each other out but offer us a full range of power and response to life “Healing is in the Head”.We cannot deny the fact that placebos have shown, it can provide the clearest insight into what a treatment can accomplish, the use of placebos have often lead to substantial improvement.

Rather than accepting placebo as a deception, we advance the speculation that placebo can empower patients, and trigger self-healing, an additional reason why prescribing placebos can be ethical is because not only does it make the patient think mentally that it helps, but also it can also be viewed as a sourse of insight into mental health.

Hey Amber,Wesam and Selma, this is what I have come up with so far please edit/make changes as you deem necessary.

Did you all get my email? Let's communicate on wiki Group Communication Page as it is more easier to see each other's responses.

Refrences:

1. http://arthritis.about.com/od/arthritistreatments/g/placebo.htm?terms=water+pill

2. http://www.skeptics.org.uk/explanation.php?dir=articles/explanations&article=placebo_effect.php

3. http://arthritis.about.com/od/researchandadvancements/a/powerplacebos.htm

4. http://enc3250.pbwiki.com/WeekFour

5. http://www.avatarepc.com/html/placebo9-4.html

6. http://en.wikipedia.org/wiki/Placebo

7. http://www.medterms.com/script/main/art.asp?articlekey=31481

8. http://skepdic.com/placebo.html

9. http://serendip.brynmawr.edu/bb/neuro/neuro00/web2/Iyer.html

10. http://www.cerebromente.org.br/n09/mente/placebo1_i.htm

HealingIsInTheHeadProposalGraded