Placebos Essays (1376 words) - Clinical Research, Medical Ethics

Placebos Why we need placebos English/ History By Jj wallis A placebo is defined as an inactive substance resembling a medication, given for psychological effect or as a control in evaluating a medicine believed to be active. However the placebo only fits this description under the restraints it has been given by the U.S. Food and Drug Administration, which refers to the placebo as an investigational new drug. In actuality, up until the present much of medicine was built on placebos. Not very long ago, the rituals and symbols of healing constituted the bulk of the physicians armamentarium. In the early decades of the 20th century, most of the medication that doctors carried in their little black bags and kept in their office cabinets had little or no pharmacological value against the maladies for which they were prescribed. Nevertheless, their use in the appropriate clinical context was no doubt frequently beneficial.(Brown, 6) Even though placebos have been proven effective medicine time and time again the FDA remains reluctant to approve them for anything more than clinical research. The FDA stands on their disapproval of placebos as medicine on the basis that patients are to be given the best treatment available. Who is to say that a placebo is not as, if not more effective than the accepted remedy? There are an endless variety of cases that have proven placebos inconclusively effective. Among the most famous of these cases is the story of Mr. Wright, who was found to have cancer and in 1957 was given only days to live. Hospitalized in Long Beach, California, with tumors the size of oranges, he heard that scientists had discovered a horse serum, Krebiozen, that appeared to be effective against cancer. After Wright begged to receive the serum, his physician, Dr. Philip West, finally agreed and gave wright the injection on a Friday afternoon, not telling Wright that injection consisted only of water. The following Monday the doctor was astonished to find that the patient's tumors were gone. Dr. West later wrote the tumors, had melted like snowballs on a hot stove. At Tulane University, Dr. Eileen Palace has been using a placebo to restore sexual arousal in women who say they are nonorgasmic. The women are hooked up to a biofeedback machine that they are told measures their vaginal blood flow, an index of arousal. Then they are shown sexual stimuli that would arouse most women. The experiment then tricks the women by sending a false feedback signal, within 30 seconds, that their vaginal blood flow has increased. Almost immediately after they become genuinely aroused. In another case a study was carried out in Japan on 13 people that were extremely allergic to poison ivy. Each individual was rubbed on one arm with a harmless leaf and told that it was poison ivy and then rubbed on the opposite arm with poison ivy and told that it was harmless. All thirteen broke out in a rash where the harmless leaf had contacted their arm. Only two reacted to the poison ivy leaves. (Blakeslee, 2) In yet another example, patients with angina pectoris, chest pain, associated with heart disease, have been shown to improve substantially following an operation that involved nothing more than a simple skin incision. Angina also improved following a type of artery surgery once thought to be effective but later found to be ineffective. (Turner, 1) These are just a few of a great number of cases that prove the effectiveness of placebos. How do placebos work? There are many theories on how placebos work but really no definite answers. Many believe that the response to placebos is one of conditioning. That is that the site of a doctor, his white coat, the sterile smell, and a prescribed medication is equated with being cured, and because we think that we will get better we do. Some think that a placebo might reduce stress, allowing the body to regain some natural optimum level of health. Others believe that special molecules in the brain help carry out the placebo effect. A recent study found that stressed animals could produce a valium like substance in their brain if they have some control over the source of the stress. People must certainly share