Edgar, I experience what I experience. You experience what you experience. That is the only reality that either of us have available to us.
All the rest that you claim to exist is speculation, intellectualizations; in other words delusions. ...Bill! --- In Zen_Forum@yahoogroups.com, Edgar Owen <edgarowen@...> wrote: > > Bill, > > Yes, you experience what you experience whatever. But it isn't reality > because it's different between observers... > > There is an actual external reality that each observer experiences it > differently... > > But why O why am I wasting my time trying to teach you the obvious, a > teaching that every Zen master from Buddha onward agrees with me on? > > Edgar > > > > On Jul 14, 2013, at 8:14 PM, Bill! wrote: > > > Merle, > > > > If you are color-blind or totally blind it makes no difference. You > > experience what you experience. That which you experience is real. That > > which you perceive (think about, intellectualize) is not. > > > > We do interpret our experiences with our mind. That's called perceiving. > > And just as you say we interpret them to make sense out of them, but it's > > WE, our human intellect, that 'makes the sense'. It's not as many believe > > that our intellect 'discovers' the sense which is inherent in experience. > > We create it and we superimpose it, force-fit it, onto our experience. > > > > And yes, you're correct again that we perceive (apply our intellect)in > > order to survive. That doesn't make our perceptions real, it only makes > > them useful. > > > > Our intellect does not make things real. Our intellect takes our experience > > of reality and forces it into a little logical box so we can understand it. > > Our intellect distorts reality. That's called perception and is a delusion > > (or illusion). > > > > I'm not sure what you mean by 'and then there is a consensus' so I cannot > > comment on that. > > > > ...Bill! > > > > --- In Zen_Forum@yahoogroups.com, Merle Lester <merlewiitpom@> wrote: > > > > > > > > > > > >  so if one was colour blind...how would that fit into the scheme of > > > things? > > > ..it would not be the correct interpretation of the world..for instance > > > traffic lights.. > > > > > > i do not believe one can totally trust our senses as being the only real > > > experience...what ever you mean by real...we see  we hear we touch we > > > smell we taste... > > >  one interpret this with our mind... > > > otherwise this world would make no sense what so ever... > > >  one must in order to survive make meaning out of what we see, hear, > > > touch, smell and taste... > > > what other experiences are there apart from the sensory?... > > > i'd say they are the starting point not the all end to understanding the > > > world... > > > we need our minds to make sense of the world surely?...and hence an > > > intellect... > > >  then it becomes real real real... and one is able to communicate that > > > reality to others > > >  and then there is a consensus > > > > > > merle > > > > > >  > > > Merle, > > > > > > IMO only experience is real, and by that 'experience' I mean sensory > > > experience (sight, sound, touch, smell, taste). > > > > > > That's it. That's all. > > > > > > ...Bill! > > > > > > --- In Zen_Forum@yahoogroups.com, Merle Lester <merlewiitpom@> wrote: > > > > > > > > > > > > > > > > àbill..thank you for your clarification...so what is NOT an illusion > > > > bill?...and what is real in your world?...merle > > > > > > > > > > > > à> > > > Merle, > > > > > > > > Sure...as long as you tie it back to zen it's fair game as far as I'm > > > > concerned. What this article is talking about is what Buddhism calls > > > > 'suffering'. > > > > > > > > Western medicine tries to alleviate it by prescribing medications. > > > > > > > > Most religions try to alleviate it by prescribing faith in God. > > > > > > > > Art, music, work, activities of all sorts, etc.. help alleviate it by > > > > having you concentrate on something else. > > > > > > > > Zen IMO tries to alleviate it by helping you experience these are > > > > delusive. > > > > > > > > ...Bill! > > > > > > > > --- In Zen_Forum@yahoogroups.com, Merle Lester <merlewiitpom@> wrote: > > > > > > > > > > > > > > > > > > > > Ãâài thought this was a good article as to what bill talks > > > > > about..illusions... hence zen appropriate..correct me if i am > > > > > incorrect...bill... > > > > > merle > > > > > > > > > > > > > > > > > > > > > > > > > > > > > >Worried Sick > > > > > >Expectations can make you ill. Fear can make you fragile. > > > > > >Understanding the nocebo effect may help prevent this painful > > > > > >phenomenon. > > > > > >ByÃâàMegan ScudellariÃâà|ÃâàJuly 1, 2013 > > > > > >Ãâé BRYAN SATALINO > > > > > >Something strange was happening in New Zealand. In the fall of 2007, > > > > > >pharmacies across the country had begun dispensing a new formulation > > > > > >of Eltroxinâââ¬"the only thyroid hormone replacement drug > > > > > >approved and paid for by the government and used by tens of > > > > > >thousands of New Zealanders since 1973. Within months, reports of > > > > > >side effects began trickling in to the governmentâââ‰â¢s > > > > > >health-care monitoring agency. These included known side effects of > > > > > >the drug, such as lethargy, joint pain, and depression, as well as > > > > > >symptoms not normally associated with the drug or disease, including > > > > > >eye pain, itching, and nausea. Then, the following summer, the > > > > > >floodgates opened: in the 18 months following the release of the new > > > > > >tablets, the rate of Eltroxin adverse event reporting rose nearly > > > > > >2,000-fold.1 > > > > > >The strange thing was, the active ingredient in the drug, thyroxine, > > > > > >was exactly the same. Laboratory testing proved that the new > > > > > >formulation was bioequivalent to the old one. The only change was > > > > > >that the drugmaker, GlaxoSmithKline, had moved its manufacturing > > > > > >process from Canada to Germany, and in the process altered the > > > > > >drugâââ‰â¢s inert qualities, including the > > > > > >tabletsâââ‰â¢ size, color, and markings. > > > > > >So why were people getting sick? In June, it turned out, newspapers > > > > > >and TV stations around the country had begun to directly attribute > > > > > >the reported adverse effects to the changes in the drug. Following > > > > > >widespread coverage of the issue, more and more patients reported > > > > > >adverse events to the government. And the areas of the country with > > > > > >the most intense media coverage had the highest rates of reported > > > > > >ill effects, suggesting that perhaps a little social persuasion was > > > > > >at play. > > > > > >ââ∠"Noceboââ⬠(meaning ââ∠"I shall > > > > > >harmâââ¬) is the dastardly sibling of placebo (ââ∠> > > > > >"I shall pleaseâââ¬). > > > > > >But Eltroxin takers were not making up their symptoms. The feelings > > > > > >were real, but in the vast majority of cases they could not be > > > > > >attributed to the drugâââ‰â¢s pharmacological > > > > > >properties. The patients were victims of the nocebo effect. > > > > > >ââ∠"Noceboââ⬠(meaning ââ∠"I shall > > > > > >harmâââ¬) is the dastardly sibling of placebo (ââ∠> > > > > >"I shall pleaseâââ¬). In a placebo response, a sham > > > > > >medication or procedure has a beneficial health effect as a result > > > > > >of a patientâââ‰â¢s expectation. Sugar pills, for > > > > > >example, can powerfully improve depression when the patient believes > > > > > >them to be antidepressants. But, researchers are learning, the > > > > > >reverse phenomenon is also common: negative expectations can > > > > > >actually cause harm. > > > > > >When Parkinsonâââ‰â¢s patients undergoing deep brain > > > > > >stimulation were told that their brain pacemaker was going to be > > > > > >turned off, symptoms of their illness became more pronounced, even > > > > > >when the pacemaker was left on.2ÃâàWhen people with and > > > > > >without lactose intolerance were asked to ingest lactose, but were > > > > > >actually given glucose, 44 percent of those with lactose intolerance > > > > > >and 26 percent of those without it still complained of stomach > > > > > >pain.3ÃâàAnd men treated for an enlarged prostate with a > > > > > >commonly prescribed drug and told that the drug ââ∠"may > > > > > >cause erectile dysfunction, decreased libido, [and] problems of > > > > > >ejaculation,ââ⬠but that these effects were ââ∠> > > > > >"uncommon,ââ⬠were more than twice as likely to experience > > > > > >impotence as those who were not so informed.4 > > > > > >On paper, it sounds like psychobabbleâââ¬"a negative effect > > > > > >caused by a sham treatment based on a patientâââ‰â¢s > > > > > >expectationsâââ¬"but it is a real biochemical and > > > > > >physiological process, involving pain and stress pathways in the > > > > > >brain. And mounting evidence suggests that the nocebo effect is > > > > > >having a substantial negative impact on clinical research, medicine, > > > > > >and health. > > > > > >ââ∠"Nocebo is at least as important as the placebo effect > > > > > >and may be more widespread,ââ⬠says Ted Kaptchuk, director > > > > > >of Harvardâââ‰â¢s Program in Placebo Studies at Beth > > > > > >Israel Deaconess Medical Center in Boston, Massachusetts. > > > > > >Now that this pernicious phenomenon is starting to receive the > > > > > >recognition it deserves, the question is: What exactly can be done > > > > > >about it? > > > > > >Evil effects > > > > > >ALLERGIC TO NOCEBO > > > > > >Ãâé BRYAN SATALINO > > > > > >According to several recent studies, pain and itch appear to be > > > > > >especially susceptible to verbal suggestion. Recently, researchers > > > > > >in the Netherlands demonstrated that people who are told that a > > > > > >stimulus will cause itch feel the itch more intensely than those > > > > > >told that the stimulus is unlikely to cause itch. The finding could > > > > > >have implications for chronic itch conditions, says first author > > > > > >Antoinette van Laarhoven of Radboud University Nijmegen Medical > > > > > >Center. ââ∠"More knowledge about nocebo effects on itch > > > > > >can give us some targets to reduce [those effects].ââ⬠> > > > > >Also last year, in a curious study of nocebo and rectal pain, a team > > > > > >at University Hospital Essen in Germany managed to recruit healthy > > > > > >volunteers to undergo multiple rectal balloon distensions, a > > > > > >procedure in which a balloon is inserted into the rectum and slowly > > > > > >inflatedâââ¬"in this case, until the moment it becomes > > > > > >painful. The procedures were exactly the same in control and nocebo > > > > > >groups, but there was a 20 percent increase in pain ratings among > > > > > >patients who had been told that doctors had observed an increase in > > > > > >pain sensitivity in response to repeated distensions. Those > > > > > >individuals who experienced more pain also had elevated levels of > > > > > >cortisol, again linking nocebo to anxiety. ââ∠"We could > > > > > >show that a nocebo effect may be induced even by mere > > > > > >information,ââ⬠says Sven Benson, an author on the paper. > > > > > >Another area of health that researchers suspect may be affected by > > > > > >nocebo is the increased incidence of asthma and allergies. > > > > > >ââ∠"Itâââ‰â¢s certainly possible,ââ⬠> > > > > >says Manfred Schedlowski, who studies placebo and the immune system > > > > > >at University Hospital Essen. ââ∠"From experimental data, > > > > > >we know an allergic reaction can be conditioned.ââ⬠> > > > > >In an oft-cited case from 1886, John Mackenzie, a surgeon in > > > > > >Baltimore, described how heâââ‰â¢d ââ∠> > > > > >"obtained an artificial rose of such exquisite workmanship that it > > > > > >presented a perfect counterfeit of the original,ââ⬠then > > > > > >exposed a woman with severe rose allergy to the fake flower. The > > > > > >woman, not knowing it was fake, had a full-blown allergic reaction, > > > > > >including a running nose, swollen nostrils, and a tight chest.12 > > > > > >Similarly, people allergic to dogs may begin sneezing when they > > > > > >simply see a dog across the way. Researchers have even shown that > > > > > >guinea pigs can be conditioned to release histamine, causing a local > > > > > >immune response, when presented with just an odor stimulus. > > > > > >But the link between nocebo and allergy is far from concrete. > > > > > >ââ∠"Weâââ‰â¢re in such a primitive state of > > > > > >understanding this phenomenon, particularly in a clinically oriented > > > > > >way, that we just need to do more research,ââ⬠says > > > > > >bioethicist Frank Miller of the National Institutes of Health. > > > > > >In 1997, Fabrizio Benedetti, a neurophysiologist at the University > > > > > >of Turin Medical School in Italy, was busy mapping the biochemical > > > > > >pathways involved in placebo responses when he performed a simple > > > > > >study that revealed a distinct neural mechanism driving the > > > > > >bodyâââ‰â¢s nocebo response. He gave consenting > > > > > >postoperative patients reporting mild pain an injection that they > > > > > >were told would increase their pain within 30 minutes. The injection > > > > > >was either saline solution or proglumide, which blocks a hormone > > > > > >implicated in pain hypersensitivity and associated with anxiety. > > > > > >Neither substance actually causes any discomfort. > > > > > >When saline was injected, patients experienced increased pain. When > > > > > >proglumide was injected, they had no pain increaseâââ¬"the > > > > > >nocebo effect was absent.5ÃâàIn one fell swoop, Benedetti > > > > > >identified a biochemical reaction responsible for the nocebo > > > > > >response, and he showed that it could be blocked. > > > > > >It was Benedettiâââ‰â¢s work that finally convinced > > > > > >physician-bioethicist Howard Brody that the nocebo > > > > > >effectâââ¬"allegedly first mentioned in the scientific > > > > > >literature in 1961 by physician Walter Kennedy, who called the > > > > > >phenomenon a ââ∠"quality inherent in the patient rather > > > > > >than in the remedyâââ¬Ã¢ââ¬"was real. > > > > > >ââ∠"For many years, I dismissed the value of the term > > > > > >âââ¬ÃÅ"nocebo,âââ‰â¢Ã¢ââ‰â¬Â°Ã¢â⬠> > > > > > says Brody, chair of family medicine and director of the Institute > > > > > >for the Medical Humanities at the University of Texas Medical Branch > > > > > >in Galveston, who first began studying the placebo effect in the > > > > > >1970s. He and others had long assumed that nocebo and placebo were > > > > > >two sides of one coin, that the same process in the brain supported > > > > > >both illusory effectsâââ¬"one was just manifested as a > > > > > >positive outcome, while the other caused harm. But after reading > > > > > >Benedettiâââ‰â¢s work, Brody changed his tune: > > > > > >ââ∠"I received my comeuppance,ââ⬠he laughs. > > > > > >With that first biochemical evidence, others also began recognizing > > > > > >the importance of nocebo, and a few inquiring minds began to study > > > > > >it. Nevertheless, compared to placebo, the nocebo effect remains > > > > > >vastly understudied: a PubMed database search will turn up more than > > > > > >163,000 publications on ââ∠"placeboââ⬠and fewer > > > > > >than 200 on ââ∠"nocebo.ââ⬠Of those, only a few > > > > > >dozen are empirical studies; most are reviews. ââ∠"The > > > > > >placebo phenomenon has a tremendous fascination for the > > > > > >publicâââ¬"a gee-whiz thing with a positive spin, a way to be > > > > > >healthy without taking drugs,ââ⬠says Frank Miller, a > > > > > >bioethicist at the National Institutes of Health. ââ∠"But > > > > > >nobody is very enthusiastic about the nocebo phenomenon.ââ⬠> > > > > >In addition, the nocebo effect has become notoriously difficult to > > > > > >study. Few institutional review boards will allow scientists to > > > > > >induce pain in their subjects, and some even refuse to let > > > > > >researchers mislead their volunteers. ââ∠"My ethics > > > > > >committee will not allow me to do it,ââ⬠says Paul Enck, a > > > > > >psychologist at the University of TÃÆ'übingen in Germany, > > > > > >ââ∠"unless I tell the subjects that I am deceiving > > > > > >themâââ¬Ã¢ââ¬"a requirement that obviously defeats the > > > > > >purpose of the deception. ââ∠"It makes life really > > > > > >miserable as a [nocebo] researcher,ââ⬠says Enck. > > > > > >The tragedy of this lack of investigation, researchers assert, is > > > > > >that controlled trials about the nocebo effect are needed to further > > > > > >understand and prevent noceboâââ‰â¢s insidious effects > > > > > >on medicine and research. ââ∠"In clinical drug trials, the > > > > > >placebo effectâââ¬"and now we know the nocebo > > > > > >effectâââ¬"can be really, really large,ââ⬠says > > > > > >Manfred Schedlowski, a clinical researcher at the University > > > > > >Hospital Essen in Germany. ââ∠"This hinders the > > > > > >development of new drugs.ââ⬠> > > > > >In December 2012, for example, a meta-analysis revealed the > > > > > >shockingly large impact of the nocebo effect in clinical trials: in > > > > > >18 fibromyalgia drug studies, 11 percent of 3,546 patients in the > > > > > >placebo armâââ¬"meaning they were receiving a completely > > > > > >inert substanceâââ¬"dropped out of the study because of side > > > > > >effects including dizziness and nausea.6ÃâàOther studies have > > > > > >calculated that nocebo effects cause between 4 and 26 percent of > > > > > >patients taking placebo to leave a clinical trial because of side > > > > > >effects from an inert treatment. > > > > > >The nocebo effect may also have a worrisome effect on vaccine use. > > > > > >In 2011, researchers at the French vaccine manufacturer Sanofi > > > > > >Pasteur analyzed 33,275 vaccine side-effect reports and found that > > > > > >doctors and patients preferentially report disease-specific side > > > > > >effects, such as measles-like rash following measles immunization, > > > > > >even when the vaccine contains only proteins, sugars, or killed > > > > > >organisms that wonâââ‰â¢t cause symptoms of the disease. > > > > > >The nocebo effect has ââ∠"great potentialââ⬠to > > > > > >exacerbate rumors and fears, and to cause a vaccine crisis similar > > > > > >to the Eltroxin events in New Zealand, the authors write.7 > > > > > >But the most common place where the nocebo effect makes an > > > > > >appearance is in everyday visits to clinics and hospitals. > > > > > >ââ∠"In places like primary care, people are swimming in > > > > > >placebo and nocebo effects,ââ⬠says Kaptchuk. > > > > > >Thomas Dâââ‰â¢Amico, chief of thoracic surgery at Duke > > > > > >University Medical Center in Durham, North Carolina, says that even > > > > > >before he heard the term nocebo effect, he was aware of it in the > > > > > >clinic. ââ∠"Iâââ‰â¢ve listened to some > > > > > >well-respected colleagues give information [to a patient], and I > > > > > >thought, âââ¬ÃÅ"Gosh, I know the operation and even I > > > > > >wouldnâââ‰â¢t want it,âââ‰â¢Ã¢â⬠he > > > > > >says. ââ∠"Thereâââ‰â¢s too much detail and too > > > > > >much emphasis about things that could go wrong.ââ⬠Measuring > > > > > >the effect of such detail on an individual patient is hard to > > > > > >quantify, he says, but fear and distress before an operation has > > > > > >been associated with slow postoperative recovery and delayed wound > > > > > >healing. > > > > > >Nuts and bolts > > > > > >Ãâé BRYAN SATALINODespite the disproportionate amount of > > > > > >effort put into placebo research, since Benedettiâââ‰â¢s > > > > > >1997 discovery thereâââ‰â¢s been an uptick in the > > > > > >funding and time devoted to investigating the mechanisms behind > > > > > >nocebo, with impressive results. ââ∠"Without a doubt, > > > > > >thereâââ‰â¢s been a level of research and a > > > > > >sophistication of research that has made a quantum jump in the last > > > > > >decade or so,ââ⬠says Brody. > > > > > >In 2007, for example, Benedetti discovered that the > > > > > >hypothalamic-pituitary-adrenal axis in the brain, an important part > > > > > >of the bodyâââ‰â¢s ââ∠"stress > > > > > >system,ââ⬠is activated during a nocebo response, as > > > > > >detected by an increase in the secretion of the hormones ACTH, from > > > > > >the pituitary gland, and cortisol, from the adrenal gland, both > > > > > >markers of anxiety.8 > > > > > >Then, in 2008, Kaptchuk and colleagues at Harvard performed the > > > > > >first brain-imaging study of the nocebo effect. After conditioning > > > > > >healthy volunteers to expect pain on their right forearm, they > > > > > >watched as the hippocampus lit up when people experienced pain from > > > > > >a sham acupuncture device. > > > > > >Through Benedettiâââ‰â¢s and Kaptchukâââ‰â¢s > > > > > >work, it is now clear that a personâââ‰â¢s expectation > > > > > >of pain can induce anticipatory anxiety, triggering the activation > > > > > >of cholecystokinin, the hormone that Benedetti blocked with > > > > > >proglumide. Cholecystokinin-mediated pathways in turn facilitate > > > > > >pain transmission, which occurs in specific areas of the brain. The > > > > > >finding does not coincide with what is know about the biochemistry > > > > > >of the placebo effectâââ¬"which seems to be at least partly > > > > > >regulated by opioid releaseâââ¬"suggesting the two phenomena > > > > > >have distinct mechanisms. > > > > > >ââ∠"Even if placebo and nocebo are on a continuum of > > > > > >expectation, different mechanisms kick in at different points along > > > > > >that continuum,ââ⬠says Tor Wager, director of the Cognitive > > > > > >and Affective Control Laboratory at the University of Colorado, > > > > > >Boulder, who studies the brain pathways underlying pain. > > > > > >Last year, Kaptchuk and colleagues added a surprising twist when > > > > > >they discovered nocebo can occur without conscious awareness. His > > > > > >team applied either high or low heat pain to the arms of 20 > > > > > >volunteers while showing them an image of one of two faces. The > > > > > >researchers then showed the volunteers the faces again, but with > > > > > >identical, moderate heat applied to their arms each time and the > > > > > >faces displayed at a much faster pace, preventing conscious > > > > > >recognition. When exposed to the faces associated with high pain > > > > > >levels, even without conscious awareness, the volunteers felt more > > > > > >pain.9Ãâàââ∠"It was a really risky > > > > > >experiment,ââ⬠says Kaptchuk. ââ∠"We were really > > > > > >surprised. We couldnâââ‰â¢t believe it, > > > > > >actually.ââ⬠> > > > > >The biochemical and physiological discoveries about nocebo have made > > > > > >the phenomenon more credible in the medical community. ââ∠> > > > > >"These brain measures provide objective evidence on the physical > > > > > >system implementing these squishy, fuzzy changes in emotion and > > > > > >expectation,ââ⬠says Wager. > > > > > >Most nocebo research to date, however, focuses on basic mechanisms, > > > > > >not on how to deal with the phenomenon in the clinic. ââ∠> > > > > >"Translational research has been a stepchild in scientific > > > > > >investigations of this phenomenon,ââ⬠says Miller. > > > > > >Understanding the mechanism is important, but at the end of the day, > > > > > >he says, the medical community needs a solution to the problem. > > > > > >Controlling for nocebo > > > > > >In 1987, a team of doctors in Ontario, Canada, suspected that > > > > > >medical consent forms might actually cause harm. Using the chance > > > > > >occurrence of two different consent forms being used for the same > > > > > >drug trial, they compared patient reactions to the wording of the > > > > > >forms. The trial pitted aspirin against sulfinpyrazone, a medicine > > > > > >already approved to treat gout, as a treatment for chest pain. > > > > > >Patients at two of the three centers hosting the trial were informed > > > > > >that ââ∠"side effects are not anticipated beyond > > > > > >occasional gastrointestinal irritation and, rarely, skin > > > > > >rash.ââ⬠At the third center, patientsâââ‰â¢ > > > > > >consent forms did not mention gastrointestinal effects. Seventy-six > > > > > >patients out of 399 (19 percent) given the first consent form that > > > > > >mentioned GI irritation withdrew from the study, citing GI issues, > > > > > >compared to just 5 out of 156 (3 percent) who received the second > > > > > >form.10 > > > > > >With the nocebo effect, doctors are caught between a rock and a hard > > > > > >place: their medical duty to primum non nocere, ââ∠"First, > > > > > >do no harm,ââ⬠and the ethical and regulatory obligation of > > > > > >informed consent. What do you do when informed consent leads to harm? > > > > > >Last year, Kaptchuk and colleague Rebecca Wells, also at Harvard > > > > > >Medical School, sparked a debate on this topic in the pages of > > > > > >theÃâàAmerican Journal of Bioethics. They proposed a middle > > > > > >ground called contextualized informed consent. Doctors, they > > > > > >suggested, might choose not to tell patients every last side effect > > > > > >of a treatment in great detail, but instead provide information to a > > > > > >patient tailored to his or her level of anxiety, such as leaving out > > > > > >nonspecific side effectsâââ¬"those that are not a direct > > > > > >result of the pharmacological action of the > > > > > >drugâââ¬"including headache, nausea, and fatigue. > > > > > >Nocebo is at least as important as the placebo effect and may be > > > > > >more widespread.âââ¬"ÃâàTed Kaptchuk, Program in > > > > > >Placebo Studies, > > > > > >>Beth Israel Deaconess Medical Center, Harvard University > > > > > >But the idea of not informing patients of all possible side effects > > > > > >is anathema to some ethicists. ââ∠"I certainly > > > > > >donâââ‰â¢t think that we should be rethinking whether > > > > > >informed consent should be a basic norm in clinical > > > > > >practice,ââ⬠says Miller. Such a practice could promote > > > > > >mistrust in the health-care system and defeat recent efforts towards > > > > > >increased transparency. It may not be possible to have valid > > > > > >informed consent with no chance of the nocebo phenomenon, Miller > > > > > >admits, but he proposes two alterative techniques. > > > > > >One is to frame information about treatments positively rather than > > > > > >negatively. A 1996 study from the University of Ottawa in Canada, > > > > > >for example, described the benefits and risks of a vaccine to 292 > > > > > >people, who had never been previously immunized, using tw > > > > > > > > > > > > ------------------------------------ Current Book Discussion: any Zen book that you recently have read or are reading! Talk about it today!Yahoo! 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