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The powerful Nocebo effect!

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  • The powerful Nocebo effect!

    An interesting newspaper article.

  • #2
    The nocebo effect is well known, but just as with placebo there are limits to what can be achieved.

    I don't think there is evidence to support, that the nocebo effect can accelerate death, as the first paragraph in the article suggests. Just as there is no evidence to support the placebo effect can postpone death.

    Here is a review from 2008: ScienceDirect - Neuron : New Insights into the Placebo and Nocebo Responses

    Comment


    • #3
      Originally posted by JLI View Post
      The nocebo effect is well known, but just as with placebo there are limits to what can be achieved.

      I don't think there is evidence to support, that the nocebo effect can accelerate death, as the first paragraph in the article suggests. Just as there is no evidence to support the placebo effect can postpone death.
      There is evidence -- as my link states.

      Comment


      • #4
        Originally posted by Interesting Ian View Post
        There is evidence -- as my link states.
        Your link states that a man died after he was told that he had 2 months to live. An intern didn't believe he died of cancer, but couldn't find any other anatomical explanation. This is not evidence that nocebo caused his death.

        I have working experience in performing autopsies, and it is not uncommon that we don't find anatomical changes that explain the cause of death And most of the cases I do autopsies on are those where death came as a sudden surprise.

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        • #5
          Originally posted by JLI View Post
          Your link states that a man died after he was told that he had 2 months to live. An intern didn't believe he died of cancer, but couldn't find any other anatomical explanation. This is not evidence that nocebo caused his death.

          I have working experience in performing autopsies, and it is not uncommon that we don't find anatomical changes that explain the cause of death And most of the cases I do autopsies on are those where death came as a sudden surprise.
          Now you've changed your claim. It's gone from "evidence" to "strong evidence". And of course "strong evidence" can be interpreted to mean anything.

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          • #6
            Interesting article .... my father died of cancer a few years ago ... right up to the day of his diagnosis he was walking around the local park twice a day ... after the doctor told him he had incurable lung cancer, he never walked around a park again, he was too weak. Within a few days of diagnosis he could hardly walk, talk or do anything like before.

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            • #7
              The article says ....

              In 1992 the Southern Medical Journal reported the case of a man who in 1973 had been diagnosed with cancer and given just months to live. After his death, however, his autopsy showed that the tumour in his liver had not grown. His intern Clifton Meador didn't believe he'd died of cancer: "I do not know the pathologic cause of his death," he wrote. Could it be that, instead of the cancer, it was his expectation of death that killed him?
              Notice that the assumption is always that only the patient's expectation can affect the patient ... but what if ......

              Do doctors who think their patient has an incurable disease make the patient more incurable?

              Has conventional medicine ever done experiments to properly rule out this possibility? Alarmingly, I don't think so.

              This is surely an important question ....can the expectations, not just of ourself but of other people affect our outcomes?

              '.... A person adversely affecting an experiment in extrasensory perception does not need to be physically present with the percipient. Schmeidler (1961a, 1961b) showed that the scores of percipients at card-guessing tended to be high or low according to whether an agent was wishing the percipient to succeed or to fail. Some experiments even suggest that unfavorable influences may not reach the level of an overt wish that a percipient would fail; much more subtle negative qualities may come into play (West and Fisk, 1953).....' - Dr Ian Stevenson
              Do drugs become less effective as doctors come to regard these as inferior to new treatments?

              '...a study by Daniel Moerman looked at 117 studies of ulcer drugs from 1975 to 1994 ......

              Cimetidine was one of the first anti-ulcer drugs on the market, and it is still in use today. In 1975, when it was brand new, it eradicated 80% of ulcers, on average, in various different trials. But as time passed the success rate of cimetidine – this very same drug – deteriorated to just 50%....


              So what happened between 1975 and 1994?

              Could it be the new drugs (and helicobacter pylori antibiotics) came out , doctors (colective) faith in old drug Cimetidine reduced affecting their patients outcoms too?

              When will mainstream medicine take parapsychology seriously enough to test their 'gold standard' double blind randomized controlled trials are truly free from experimenter expectations?
              Last edited by Open Mind; November 15th, 2011, 08:29 PM.

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              • #8
                Originally posted by Interesting Ian View Post
                Now you've changed your claim. It's gone from "evidence" to "strong evidence".
                This is the first time "strong" is mentioned in this thread

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                • #9
                  Originally posted by Open Mind View Post
                  When will mainstream medicine take parapsychology seriously enough to test their 'gold standard' double blind randomized controlled trials are truly free from experimenter expectations?
                  Death is an accepted endpoint in non placebo controlled trials. But randomisation is very important to ensure that likes are compared with likes.

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                  • #10
                    Originally posted by Open Mind View Post
                    Interesting article .... my father died of cancer a few years ago ... right up to the day of his diagnosis he was walking around the local park twice a day ... after the doctor told him he had incurable lung cancer, he never walked around a park again, he was too weak. Within a few days of diagnosis he could hardly walk, talk or do anything like before.
                    I'd call that evidence of a sort. As a doctor, I wonder if JLI has come across many similar cases.

                    I can't imagine how anyone could (ethically!) collect direct evidence of the nocebo effect!

                    David

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                    • #11
                      I am a pathologist, so I don't interact directly with patients. But it is no surprise that being given a bad message can make people feel crappy/depressed. But that is not the same as accelerating death.

                      Personally I think it is a bad idea to give time frames about life expectancy to individual patients, because those are not very reliable. At least not until the very end. But I suppose, that if someone was told back in 1973, that he had only two months to live, he would be in a pretty sick at that time.

                      In my junior days as an intern working in the wards, I have used placebo boosts to enhance the (symptomatic) effect of medications.

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                      • #12
                        Originally posted by JLI View Post
                        This is the first time "strong" is mentioned in this thread
                        Er . .you said strong evidence! But the word "strong" has now disappeared . You must have edited it out during the time I read it and when I pressed reply.

                        But now it's reverted back to evidence rather than "strong evidence" what you say is transparently false. You skeptic guys just do not understand what the word evidence means. And other words too.

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                        • #13
                          Originally posted by Interesting Ian View Post
                          Er . .you said strong You skeptic guys just do not understand what the word evidence means. And other words too.
                          What do you mean by evidence then? And what other words are you thinking of?

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                          • #14
                            Originally posted by JLI View Post
                            What do you mean by evidence then? And what other words are you thinking of?
                            Anything which gives us reason to increase the assessed likelihood of some given hypothesis or theory being correct. The likelihood might rise from a mere 0.01 to a mere 0.02 when we consider a particular piece of evidence.

                            So evidence doesn't mean "proof". Nor is the word evidence something which is only associated with science. And anecdotes are evidence -- and I mean real proper anecdotes, not the way skeptics define "anecdotes". So if someone reports seeing a pink Unicorn in their back garden, this gives evidence that pink unicorns exist.

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                            • #15
                              Originally posted by JLI View Post
                              And what other words are you thinking of?
                              Consciousness, God, atheism, materialism, dualism, idealism, science, philosophy, illusion, hallucination, soul, self, personality.

                              Sure I could think of more, but that'll do for now.

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