NetNews Usenet Archive 1992 #26/NN_1992_26.iso/spool/sci/med/20759

Text File | 1992-11-10 | 3.2 KB | 65 lines

Path: sparky!uunet!gumby!destroyer!gatech!pitt!geb
From: [e-mail] (Gordon Banks)
Newsgroups: sci.med
Subject: Re: How Often Are Placebo's Prescribed?
Message-ID: <[e-mail]>
Date: 10 Nov 92 17:32:09 GMT
References: <[e-mail]> <[e-mail]> <[e-mail]>
Sender: [e-mail]
Reply-To: [e-mail] (Gordon Banks)
Organization: Univ. of Pittsburgh Computer Science
Lines: 52

In article <[e-mail]> [e-mail] (Mark D. Kline) writes:
>
>I believe it is unethical to lie to patients.  If you prescribe an
>inert placebo to the hysteric, and tell the pt, "don't take too many of
>these pills, they're really potent" the patient might have lots of side
>effects - and might benefit.  But in the lie (the unstated violation of
>the presumption that the potency is due to biological effect) the
>doctor patient relationship - always an imbalanced one, from the power
>standpoint - becomes a manipulative con.  It is the lie - implying that
>the effect is biological when its not - that does not sit well with
>me ethically.
>

Well, tell me what you think of this:  we take patients with
suspected pseudoseizures, and while hooked up to the EEG,
say "we are now going to inject you with a medication that
will probably cause you to have a seizure, so we can record
it.  In this other syringe, we have another medicine that
will instantly stop the seizure."  We then procede, and
quite often (usually, in fact), the patient will oblige
by going into their seizure (which the EEG records as
not being a real seizure) on injection of the first, and
quiets quickly on injection of the second.  This is a pretty
certain way of telling if people have pseudoseizures.  Without
it, we would have to leave them hooked up for hours and maybe
days, costing thousands of dollars (often at taxpayer's expense)
waiting for them to have one on their own.  Of course, some
of them are so suggestible, that you can say "look, I think
he's about to seize" and they will oblige, but the "medication"
(both syringes are saline solutions) works a lot more often.
Is this lying?  True it isn't medicine in the strict sense,
but it does do what I said it would.  What would your do, Mark?

Also, when I have a hysteric, I often prescribe physical
therapy, telling them, if you really work hard, you will
get better in a week or two.  With the right encouragement
from the therapist, this works quite often.  Is that lying?
They do often get better.

>The shamans and traditional healers of old were really con artists
>manipulating the placebo effect, imho.  Most of the new agers fail to
>realize this :) Modern medicine partakes of the same ancient and
>powerful forces, and lots of newer and more powerful ones.  I believe

Absolutely!  I think that accounts for much of the success of
the alternative practitioners as well.  The mind is a very
powerful thing.
--
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Gordon Banks  N3JXP      | "I have given you an argument; I am not obliged
[e-mail]   |  to supply you with an understanding." -S.Johnson
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