Q7. Consider the following statements about Nocebo effect:

1. The phenomenon wherein a patient undergoing medical treatment may suffer from negative side effects purely due to her own negative expectations.

2. This is in contrast to the placebo effect where a patient enjoys better health due to positive expectations regarding her treatment.

a) 1 and 2 only

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b) 2 and 3 only

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c) 1 and 3 only

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d) None of the above

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Solution

The correct option is D
d) None of the above

Nocebo Effect

This refers to the phenomenon wherein a patient undergoing medical treatment may suffer from negative side effects purely due to her own negative expectations.

This is in contrast to the placebo effect where a patient enjoys better health due to positive expectations regarding her treatment.

Negative psychological expectations are believed to cause physiological changes in a patient’s body, leading to negative health effects.

Scientists have that found that patients who were warned about negative side effects of a certain medicine actually suffered these side effects even though they were only served harmless fake pills

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That placebos can cure everything from dandruff to leprosy is well known. They have a long history of use by witch doctors, faith healers, and even modern physicians, all of whom refuse to admit their efficacy. Modern distribution techniques can bring this most potent of medicines to the aid of everyone, not just those lucky enough to receive placebos in a medical testing program.

Every drug tested would prove effective if special steps were not taken to neutralize the placebo effect. This is why drug tests give half the patients the new medication and half a harmless substitute. These tests prove the value of placebos because approximately five percent of the patients taking them are cured even though the placebos are made from substances that have been carefully selected to be useless.

Most people feel that the lucky patients in a drug test get the experimental drug because the real drug provides them a chance to be cured. (1) Yet analysis shows that patients getting the placebo may be the lucky ones because they may be cured without risking any adverse effects the new drug may have. Furthermore, the drug may well be found worthless and to have severe side effects. No harmful side effects result from placebos.

Placebos regularly cure more than five percent of the patients and would cure considerably more if the doubts associated with the tests were eliminated. Cures are principally due to the patient’s faith, (2) yet the patient must have doubts knowing that he may or may not be given the new drug, which itself may or may not prove to be an effective drug. Since he knows the probability of being given the true drug is about fifty percent, the placebo cure rate would be more than doubled by removing these doubts if cures are directly related to faith.

The actual curing power of placebos probably stems from the faith of the patient in the treatment. This suggests that cure rates in the ten percent range could be expected if patients are given placebos under the guise of a proven cure, even when patients know their problems are incurable.

It may take a while to reach the ten percent level of cure because any newly established program will not have cultivated the word-of-mouth advertising needed to insure its success. One person saying “I was told that my problem was beyond medical help, but they cured me,” can direct countless people to the treatment with the required degree of faith. Furthermore, when only terminal illnesses are treated, those not cured tell no one of the failure.

Unfortunately, placebo treatment centers cannot operate as non-profit businesses. The non-profit idea was ruled out upon learning that the first rule of public medicine is never to give free medicine. Public health services know that medicine not paid for by patients is often not taken or not effective because the recipient feels the medicine is worth just what it cost him. (3) Even though the patients would not know they were taking sugar pills, the placebos cost so little that the patients would have no faith in the treatment. Therefore, though it is against higher principles, treatment centers must charge high fees for placebo treatments. This sacrifice of principles, however, is a small price to pay for the greater good of the patients.

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