Say a GP rider has lacked confidence in his bike so he is told by his team it now has better tyres, different steering geometry, and improved brakes - he goes out and sets better lap times. But actually the bike was unchanged, the difference in confidence was psychological. Say a patient has been suffering from an uncomfortable complaint so he is prescribed a medicine - he feels some relief. But actually it was a placebo (homeopathic medicine, as it is now called). There was no difference physically or medically but purely in the patient's belief. Say a person on his deathbed is in an agony of fear and misery so a priest comes and says certain mumbo-jumbo words over him - the dying man is calmer in his mind, his passing eased. But actually the process has no basis in the real world, only in the believer's mind. The issue is this: Can it ever be right to tell lies when there is a real psychological benefit to someone and no harm done? Can homeopathy, prayers, etc ever be justified? Or is reality and the truth always ethically the better course? What do you think?
I think there is a difference between placebo and Homeopathy. The third paragraph is the entire basis of religion isn't it ? therefore complete nonsense as far as i am concerned. At the level of the individual and his priest in the final hours ,i have no idea whether its justified but probably yes. Yes, only because that moment is not the time to challenge the entirety of the thing in the dying mans company. If we could rid the world of the whole thing so that the difficult moment is avoided then that is a good goal to aim for. I disagree with the notion of "no harm done" though.
yes and no,it all depends on the person your talking to and how much you/they will and want to accept as a truth.even when they/you know inside its a lie.it all depends on the situation and how the person likes to think.its a tricky question that one,which not many people understand.
If the doctor says "Drink this, it will make you feel better" and it does make you feel better, then the statement was not a lie. But implicit in the statement is an assertion that the medicine contains some real active ingredient, and that implication was a lie. The doctor cannot say openly that the effects are only psychological, or the placebo will no longer work.
If you're interested in the placebo effect there's some fascinating stuff in Ben Goldacre's Bad Science book - even studies where people were told that what they were getting was a sugar pill yet still it had an effect (i.e. where the lie element which concerns you is present to a much lesser extent). Particularly for conditions where there is no scientifically proven effective treatment (proof normally being relative to some kind of placebo) yet there is a placebo effect (when compared with no "treatment" at all) I do wonder whether researchers should be looking more closely at what the most effective and ethical type of placebo would be. The fact that the placebo effect is real could surely be harnessed in some cases, until proper research develops "real" treatments. For example, is the most effective placebo "treatment" a sugar pill (of a particular colour - see Goldacre), some form of "therapy" involving physical contact (pseudo-massage, sham acupuncture, injection of saline), is it the almost ritualistic element of the patient performing some action (whether it is dietary changes, taking a "medicine", which gives them a sense of taking control over their condition), or is the most powerful part of a placebo effect the fact that many complementary/alternative practioners may simply spend longer listening to their patients, with longer appointments, than the standard 10 or so minutes with a GP, with that element of being listened to/acknowledged being crucial? I'm certainly not the type of person who thinks that everyone can "think themselves better" or that a positive or negative attitude will guarantee recovery or decline, but there clearly are powerful links between mind and body (for want of better terms), whereby one's emotional state and thought processes can translate into physical symptoms, whether psychosomatic illness, irritable bowel syndrome, stress affecting hormones which in turn depress the immune system, lead to long term inflammation. Finding ways of using these links to boost recovery, whether in conjunction with "real" treatment or where no real treatment exists would seem sensible. As you say, the critical thing is trying to do this ethically - perhaps what doctors could say if prescribing placebo (as opposed to proven through double blind clinical trial) treatment is "some people find that X helps" - not untrue, but not selling the placebo as more than it is.
fine with me if it cures someone - less fine if they die because they have been given a placebo overdose
The predicament I have raised depends on the stated assumption that in these cases there is no harm done. If harm is done by the lie, then there is no dilemma - truth is obviously preferable and there would be nothing to debate.
My mother was a nurse, and she used to give a spoonful of sugar with the dose of medicine. That's probably why she was suspended, after a diabetic patient had a turn for the worse.
so you asked a question with the answer you think 'If harm is done by the lie, then there is no dilemma - truth is obviously preferable and there would be nothing to debate',i'm lost now?.........
Well I would have the same confidence in my doctor to prescribe a placebo or a actual drug - if I trust him to hand out one of the may drugs available at his fingertips then why not to hand out an effective placebo
There would be no point in me raising the case of someone telling a lie which does do harm. In that case, obviously the person should not tell the lie. They should tell the truth. The ethical position would be clear and obvious, and there would be nothing to argue about. So the case I have actually raised is the more interesting one of someone telling a lie which does no harm, but rather does some good. That is the point to consider - Is telling lies so wrong you should never do it, even if it does good and does no harm? Or can telling lies be the right course of action in these special circumstances?
To discuss this sensibly, you have to establish some parameters. 1. A lie or misrepresentation may be considered the lesser of two evils. 2. There is no such thing as the lesser of two evils, there are only two evils. So, moral relativity or moral absolutism, which rule-set are we following? Without establishing that, you are discussing the length of a piece of string that has no end-points. Yes, I have had a few beers. Thanks for asking. :biggrin:
