Sep 24, 2019 08:08 PM
https://sciencebasedmedicine.org/a-world...doscience/
EXCERPT (David Gorski): . . . So it was with great interest that I was made aware by multiple people of a commentary written by Benedetti in Clinical Pharmacology & Therapeutics entitled “The Dangerous Side of Placebo Research: Is Hard Science Boosting Pseudoscience?” In it, Benedetti laments something that we’ve been lamenting ever since this blog started, namely how quacks are co-opting placebo research to justify their quackery.
I’ve likened this view of placebo effects to the New Age belief system known as The Secret, which posits that if you only want something badly enough the universe will manifest it to you and it can be yours. Indeed, placebo effects are a major aspect of what I like to call the central dogma of alternative/complementary/integrative medicine, in essence, that wishing makes it so. It’s therefore no surprise to those of us who have followed the topics of quackery, CAM, and integrative medicine over the years that quacks immediately embrace any placebo research that they can portray as “proving” the power of the mind to heal the body and that whatever woo they are peddling “works” through placebo effects.
[...] it’s hard to disagree with Benedetti’s conclusion:
"Overall, today the placebo phenomenon still remains a paradox and an effect not easy to handle. Besides the recent findings of hard science, many ethical concerns limit the implications and applications. We certainly need to pursue further research in this direction, yet the possible dangers of misuse and abuse should always be kept in mind.
"Unfortunately, quackery has today one more weapon on its side, which is paradoxically represented by the hard science–supported placebo mechanisms. This new “scientific quackery” can do a lot of damage; thus, we must be very cautious and vigilant as to how the findings of hard science are exploited. The study of the biology of these vulnerable aspects of mankind may unravel new mechanisms of how our brain works, but it may have a profound negative impact on our society as well.
"We cannot accept a world where expectations can be enhanced with any means and by anybody. This is a perspective that would surely be worrisome and dangerous. I believe that some reflections are necessary in order to avoid a regression of medicine to past times, in which quackery and shamanism were dominant. Unfortunately, the new knowledge about placebos by hard science is now backfiring on it. What we need to do is to stop for a while and reflect on what we are doing and how we want to move forward. A crucial question to answer is, Does placebo research boost pseudoscience?"
The answer to that last question is certainly yes. I don’t need to “reflect” upon anything to know that, as I’ve been reflecting on placebo research for close to 15 years now. I would also point out that medicine is already, in at least one aspect, regressing to “past times, in which quackery and shamanism were dominant”.
True, quackery and shamanism are not (yet) dominant again, but there is a whole specialty, “integrative medicine” or “integrative health,” that, while claiming to be evidence-based, nonetheless “integrates” pseudoscience and quackery such as acupuncture, “energy healing,” naturopathy, and even homeopathy, among many other forms of unscientific and pseudoscientific practices into its armamentarium of treatments, along with evidence-based lifestyle interventions, such as nutrition, exercise, and the like, thus making the quackery indistinguishable to the lay person from sensible, evidence-based recommendations. Worse, this specialty is becoming increasingly “respectable”, with institutes, divisions, and departments of integrative health popping up like kudzu in academic medical centers.
Of course, if an area of science increases our understanding of a scientific phenomenon and has arguably beneficial practical uses, it should be pursued. A lot of science can be misused ... The question to ask, I would argue, is not “Does placebo research boost pseudoscience?” The answer to that question is self-evidently yes. Rather, we should ask, “How can we mitigate the boosting of pseudoscience that placebo research inevitably produces?” Benedetti has some ideas on that topic, correctly pointing out that communication with patients is key... (MORE - details)
EXCERPT (David Gorski): . . . So it was with great interest that I was made aware by multiple people of a commentary written by Benedetti in Clinical Pharmacology & Therapeutics entitled “The Dangerous Side of Placebo Research: Is Hard Science Boosting Pseudoscience?” In it, Benedetti laments something that we’ve been lamenting ever since this blog started, namely how quacks are co-opting placebo research to justify their quackery.
I’ve likened this view of placebo effects to the New Age belief system known as The Secret, which posits that if you only want something badly enough the universe will manifest it to you and it can be yours. Indeed, placebo effects are a major aspect of what I like to call the central dogma of alternative/complementary/integrative medicine, in essence, that wishing makes it so. It’s therefore no surprise to those of us who have followed the topics of quackery, CAM, and integrative medicine over the years that quacks immediately embrace any placebo research that they can portray as “proving” the power of the mind to heal the body and that whatever woo they are peddling “works” through placebo effects.
[...] it’s hard to disagree with Benedetti’s conclusion:
"Overall, today the placebo phenomenon still remains a paradox and an effect not easy to handle. Besides the recent findings of hard science, many ethical concerns limit the implications and applications. We certainly need to pursue further research in this direction, yet the possible dangers of misuse and abuse should always be kept in mind.
"Unfortunately, quackery has today one more weapon on its side, which is paradoxically represented by the hard science–supported placebo mechanisms. This new “scientific quackery” can do a lot of damage; thus, we must be very cautious and vigilant as to how the findings of hard science are exploited. The study of the biology of these vulnerable aspects of mankind may unravel new mechanisms of how our brain works, but it may have a profound negative impact on our society as well.
"We cannot accept a world where expectations can be enhanced with any means and by anybody. This is a perspective that would surely be worrisome and dangerous. I believe that some reflections are necessary in order to avoid a regression of medicine to past times, in which quackery and shamanism were dominant. Unfortunately, the new knowledge about placebos by hard science is now backfiring on it. What we need to do is to stop for a while and reflect on what we are doing and how we want to move forward. A crucial question to answer is, Does placebo research boost pseudoscience?"
The answer to that last question is certainly yes. I don’t need to “reflect” upon anything to know that, as I’ve been reflecting on placebo research for close to 15 years now. I would also point out that medicine is already, in at least one aspect, regressing to “past times, in which quackery and shamanism were dominant”.
True, quackery and shamanism are not (yet) dominant again, but there is a whole specialty, “integrative medicine” or “integrative health,” that, while claiming to be evidence-based, nonetheless “integrates” pseudoscience and quackery such as acupuncture, “energy healing,” naturopathy, and even homeopathy, among many other forms of unscientific and pseudoscientific practices into its armamentarium of treatments, along with evidence-based lifestyle interventions, such as nutrition, exercise, and the like, thus making the quackery indistinguishable to the lay person from sensible, evidence-based recommendations. Worse, this specialty is becoming increasingly “respectable”, with institutes, divisions, and departments of integrative health popping up like kudzu in academic medical centers.
Of course, if an area of science increases our understanding of a scientific phenomenon and has arguably beneficial practical uses, it should be pursued. A lot of science can be misused ... The question to ask, I would argue, is not “Does placebo research boost pseudoscience?” The answer to that question is self-evidently yes. Rather, we should ask, “How can we mitigate the boosting of pseudoscience that placebo research inevitably produces?” Benedetti has some ideas on that topic, correctly pointing out that communication with patients is key... (MORE - details)