Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.1 6/24/83; site ttidcc.UUCP Path: utzoo!linus!philabs!ttidca!ttidcc!hollombe From: hollombe@ttidcc.UUCP (The Polymath) Newsgroups: net.med Subject: Re: Placebos can cause cancer (?!) Message-ID: <443@ttidcc.UUCP> Date: Fri, 24-May-85 14:34:30 EDT Article-I.D.: ttidcc.443 Posted: Fri May 24 14:34:30 1985 Date-Received: Sat, 25-May-85 06:37:52 EDT References: <1589@aecom.UUCP> <1273@hammer.UUCP> <437@ttidcc.UUCP> <10970@brl-tgr.ARPA> Reply-To: hollombe@ttidcc.UUCP (The Polymath) Distribution: na Organization: The Cat Factory Lines: 53 Summary: In article <10970@brl-tgr.ARPA> wmartin@brl-bmd.UUCP writes: >If you are testing a truly effective medication, say for some serious >disease or condition, and are conducting a blind or double-blind test >where some participants get placebos and some the medication, and a >number of the control group die because they got only placebos, while >all the test subjects survive because this experimental medication was >really effective, have you not violated the Hippocratic oath (and also >laid yourself open for damages, no matter what you had the participants >sign), by denying this (admittedly experimental) medication to people >who could possibly have been saved by it? Usually if there is any effective treatment for a condition at all, the new treatment will be compared to the effects of the old treatment rather than to a placebo control. This is especially true with life-threatening diseases. It is still possible, of course, that some patients on the old treatment will die for lack of the new treatment. The rationale here is that there is no way to know if the new treatment is better, or even effective at all, until the experiment is performed. Preliminary studies with animals may well lead the experimenters to expect so, but the final proof must be with human subjects. This whole area of experimental ethics is very complex and there are abuses. Questions arise with regard to coercion and what is a volunteer. This is why prison inmates are seldom used as subjects even on a "volunteer" basis. They may be doing it to get brownie points on their records and this is interpreted by some to be coercion (if they don't volunteer, they may stay in prison longer). It's also why most Universities no longer allow graduate psychology students to experiment with freshman Intro. Psych. students (my alma mater still does, but the experiments have to meet very rigid standards and be approved by a faculty ethics committee). Finally, for an example of a case where placebos are totally inappropriate, I cite the infamous L.A.P.D. "Goat Study": Seems the L.A. Police wanted to test out some new-type bullet proof vests to see if they were really more effective. So, they got some goats, wrapped them in the new vests, and opened fire at them. Of course they had to have a control group, and they did -- goats without bullet proof vests. Not surprisingly, the results of the experiment were statistically significant (very). Obviously, the controls should have been wearing the old-type vests for the experiment to be meaningful. Fortunately, the P.D. didn't have the budget to do testing with human subjects. -- -_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_-_- The Polymath (aka: Jerry Hollombe) Citicorp TTI 3100 Ocean Park Blvd. Santa Monica, CA 90405 (213) 450-9111, ext. 2483 {philabs,randvax,trwrb,vortex}!ttidca!ttidcc!hollombe