Letters in Guardian about the Placebo piece

August 31st, 2005 by Ben Goldacre in alternative medicine, bad science, homeopathy, letters, placebo, quantum physics, very basic science | 58 Comments »

Letters: Observing the benefits of placebos
Wednesday August 31, 2005
The Guardian

Ben Goldacre’s thought-provoking piece (A tonic for sceptics, August 29) moves forward the debate about homeopathy and complementary and alternative medicine (CAM). The argument is no longer about whether homeopathy works, but how it works. He is absolutely right, therefore, to single out the placebo effect as “the most interesting phenomenon in medicine”, and that it goes into the cultural meaning of treatment. But it’s a pity he stopped there, for the whole of western science is also culturally defined. For homeopathy, this raises two issues – one theoretical, the other practical.

Article continues
First, the observation problem. Physics teaches us that reality and our observation of it cannot be separated. The corollary – that any attempt at such separation can essentially destroy the “reality” under observation – is precisely what is perpetrated during blinded trials of homeopathy. Consequently, the double blind placebo-controlled trial, as applied to homeopathy and CAM, is the scientific equivalent of Nelson putting a telescope to his blind eye.

Second, if Goldacre believes “that in many cases, homeopathy does seem to help, as a complex intervention” albeit one that is “placebo, in all its rich glory” then there is no further need for debate. However homeopathy is deemed to “work”, it should be available alongside conventional medicine, where apart from its therapeutic benefits, its non-toxic and economic advantages would be appreciated.
Lionel Milgrom

Why is it that only the negative research results about homeopathy get the headlines? Take, for instance, the research done at the Institute for Pharmacy at the University of Leipzig: using concentrations of belladonna which were literally less than a drop in the ocean, statistically significant changes in the contractions of the gut of rats were measured consistently and repeatedly. The study used double-blind techniques designed to detect the placebo effect. It compared results obtained by following precisely the special stirring techniques used in homeopathy, or by ignoring them, and found a positive correlation in favour homeopathy.
Kevin Mannerings
Pforzheim, Germany

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58 Responses

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  5. UncleMonkey said,

    April 26, 2007 at 4:51 pm

    Doctor Ben,

    Doesn’t it get boring trying to convince homoeophiles that you can’t divide one gram of salt into 10E35 servings?

    You and I know we’re never going to be convinced that pure H2O can somehow remain parasalty when the last Na and Cl ions have been removed. Isn’t there a sort of unappealing combination of bullying and drudgery in endlessly reiterating the same challenge when you have no expectation of getting an intelligible explanation?

    Homoeopathy isn’t bad biochemistry/pharmacology; it’s nothing to do with science at all. Advocates seem to feel inadequate in the face of scientific medicine, cornered, even, and resort to the vocabulary of science, but this is *magic*.

    Far more interesting, I should think, to investigate why so many people prefer magic to science, and how it is that in anecdotal circumstances it sometimes works.

    (I write as one much perplexed by the sudden elimination of persistent pain of a compound fracture of the tibia, after my brother-in-law mumbled a spell and blew cheap local spirit over the site of the break. I had agreed to let him do this purely to please my wife, expecting no improvement at all. I still can’t work out how his confidence could make me feel better without my sharing it, but pain which had kept me from having a full night’s sleep for about eight months ended for good that day, without ever even a good twinge thereafter.)

    On the policy level, I can’t help thinking you’re deliberately missing the point.

    If I, knowing that homoeopathy is twaddle in the eyes of science, should nevertheless prefer going to a witch for a dose of 6E-38 g of buttercup oil to the course of vancomycin you want to prescribe, who are you to say it’s not mine to choose?

    The point of healthcare, as you doctors are all too prone to forget, is not to eliminate pathogens or produce some other objectively measurable change in the patient: it’s to make her feel better. She may be disappointed in the results of ignoring your advice, but until you can give an ironclad guarantee she will be pleased with your treatment, shouldn’t she have a choice?

  6. Ben Goldacre said,

    April 26, 2007 at 4:57 pm

    youre suggesting i go on about this, in a response to a post from septmeber 2005, almost 2 years ago?

    i have never said people should not be allowed to choose, i’ve never said it should be banned. i do this: i freely mock people for making false assertions about science and efficacy.

    why dont i write about why people prefer magic over science? oh hang on, i write about that all the time, in fact, thats what this placebo piece was about, in fact, thats exactly what i wrote about in last week’s column…

    i suggest you go and find the imaginary person your squabble is with and squabble with them.

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    IVF and Acupuncture is very important in recent days medical science. This is kind of treatment on which many diseases lower their effects dramatically.