[Zen] Re: Worried Sick..illusions

[Bill!]

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:
> > >
> > > 
> > > 
> > > Â 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... 
> > > Â one interpret this with our mind...
> > > otherwise this world would make no sense what so ever... 
> > > Â 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...
> > > Â then it becomes real real real... and one is able to communicate that 
> > > reality to others
> > > Â and then there is a consensus
> > > 
> > > merle
> > > 
> > > Â  
> > > 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:
> > > >
> > > > 
> > > > 
> > > >  bill..thank you for your clarification...so what is NOT an illusion 
> > > > bill?...and what is real in your world?...merle
> > > > 
> > > > 
> > > >   
> > > > 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:
> > > > >
> > > > > 
> > > > > 
> > > > >  i 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.
> > > > > >By Megan Scudellari | July 1, 2013
> > > > > >© 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 Eltroxinâ€"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 government’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 
> > > > > >drug’s inert qualities, including the 
> > > > > >tablets’ 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.
> > > > > >â€Å"Nocebo†(meaning â€Å"I shall 
> > > > > >harmâ€) is the dastardly sibling of placebo (â€Å
> > > > > >"I shall pleaseâ€).
> > > > > >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 drug’s pharmacological 
> > > > > >properties. The patients were victims of the nocebo effect.
> > > > > >â€Å"Nocebo†(meaning â€Å"I shall 
> > > > > >harmâ€) is the dastardly sibling of placebo (â€Å
> > > > > >"I shall pleaseâ€). In a placebo response, a sham 
> > > > > >medication or procedure has a beneficial health effect as a result 
> > > > > >of a patient’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 Parkinson’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.2 When 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.3 And men treated for an enlarged prostate with a 
> > > > > >commonly prescribed drug and told that the drug â€Å"may 
> > > > > >cause erectile dysfunction, decreased libido, [and] problems of 
> > > > > >ejaculation,†but that these effects were â€Å
> > > > > >"uncommon,†were more than twice as likely to experience 
> > > > > >impotence as those who were not so informed.4
> > > > > >On paper, it sounds like psychobabbleâ€"a negative effect 
> > > > > >caused by a sham treatment based on a patient’s 
> > > > > >expectationsâ€"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.
> > > > > >â€Å"Nocebo is at least as important as the placebo effect 
> > > > > >and may be more widespread,†says Ted Kaptchuk, director 
> > > > > >of Harvard’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
> > > > > >© 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. â€Å"More knowledge about nocebo effects on itch 
> > > > > >can give us some targets to reduce [those effects].â€
> > > > > >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 
> > > > > >inflatedâ€"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. â€Å"We could 
> > > > > >show that a nocebo effect may be induced even by mere 
> > > > > >information,†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. 
> > > > > >â€Å"It’s certainly possible,†
> > > > > >says Manfred Schedlowski, who studies placebo and the immune system 
> > > > > >at University Hospital Essen. â€Å"From experimental data, 
> > > > > >we know an allergic reaction can be conditioned.â€
> > > > > >In an oft-cited case from 1886, John Mackenzie, a surgeon in 
> > > > > >Baltimore, described how he’d â€Å
> > > > > >"obtained an artificial rose of such exquisite workmanship that it 
> > > > > >presented a perfect counterfeit of the original,†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. 
> > > > > >â€Å"We’re in such a primitive state of 
> > > > > >understanding this phenomenon, particularly in a clinically oriented 
> > > > > >way, that we just need to do more research,†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 
> > > > > >body’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 increaseâ€"the 
> > > > > >nocebo effect was absent.5 In one fell swoop, Benedetti 
> > > > > >identified a biochemical reaction responsible for the nocebo 
> > > > > >response, and he showed that it could be blocked.
> > > > > >It was Benedetti’s work that finally convinced 
> > > > > >physician-bioethicist Howard Brody that the nocebo 
> > > > > >effectâ€"allegedly first mentioned in the scientific 
> > > > > >literature in 1961 by physician Walter Kennedy, who called the 
> > > > > >phenomenon a â€Å"quality inherent in the patient rather 
> > > > > >than in the remedyâ€â€"was real.
> > > > > >â€Å"For many years, I dismissed the value of the term 
> > > > > >â€ËÅ"nocebo,’ 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 effectsâ€"one was just manifested as a 
> > > > > >positive outcome, while the other caused harm. But after reading 
> > > > > >Benedetti’s work, Brody changed his tune: 
> > > > > >â€Å"I received my comeuppance,†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 â€Å"placebo†and fewer 
> > > > > >than 200 on â€Å"nocebo.†Of those, only a few 
> > > > > >dozen are empirical studies; most are reviews. â€Å"The 
> > > > > >placebo phenomenon has a tremendous fascination for the 
> > > > > >publicâ€"a gee-whiz thing with a positive spin, a way to be 
> > > > > >healthy without taking drugs,†says Frank Miller, a 
> > > > > >bioethicist at the National Institutes of Health. â€Å"But 
> > > > > >nobody is very enthusiastic about the nocebo phenomenon.â€
> > > > > >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. â€Å"My ethics 
> > > > > >committee will not allow me to do it,†says Paul Enck, a 
> > > > > >psychologist at the University of TÃÆ'¼bingen in Germany, 
> > > > > >â€Å"unless I tell the subjects that I am deceiving 
> > > > > >themâ€â€"a requirement that obviously defeats the 
> > > > > >purpose of the deception. â€Å"It makes life really 
> > > > > >miserable as a [nocebo] researcher,†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 nocebo’s insidious effects 
> > > > > >on medicine and research. â€Å"In clinical drug trials, the 
> > > > > >placebo effectâ€"and now we know the nocebo 
> > > > > >effectâ€"can be really, really large,†says 
> > > > > >Manfred Schedlowski, a clinical researcher at the University 
> > > > > >Hospital Essen in Germany. â€Å"This hinders the 
> > > > > >development of new drugs.â€
> > > > > >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 armâ€"meaning they were receiving a completely 
> > > > > >inert substanceâ€"dropped out of the study because of side 
> > > > > >effects including dizziness and nausea.6 Other 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 won’t cause symptoms of the disease. 
> > > > > >The nocebo effect has â€Å"great potential†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. 
> > > > > >â€Å"In places like primary care, people are swimming in 
> > > > > >placebo and nocebo effects,†says Kaptchuk.
> > > > > >Thomas D’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. â€Å"I’ve listened to some 
> > > > > >well-respected colleagues give information [to a patient], and I 
> > > > > >thought, â€ËÅ"Gosh, I know the operation and even I 
> > > > > >wouldn’t want it,’†he 
> > > > > >says. â€Å"There’s too much detail and too 
> > > > > >much emphasis about things that could go wrong.†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
> > > > > >© BRYAN SATALINODespite the disproportionate amount of 
> > > > > >effort put into placebo research, since Benedetti’s 
> > > > > >1997 discovery there’s been an uptick in the 
> > > > > >funding and time devoted to investigating the mechanisms behind 
> > > > > >nocebo, with impressive results. â€Å"Without a doubt, 
> > > > > >there’s been a level of research and a 
> > > > > >sophistication of research that has made a quantum jump in the last 
> > > > > >decade or so,†says Brody.
> > > > > >In 2007, for example, Benedetti discovered that the 
> > > > > >hypothalamic-pituitary-adrenal axis in the brain, an important part 
> > > > > >of the body’s â€Å"stress 
> > > > > >system,†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 Benedetti’s and Kaptchuk’s 
> > > > > >work, it is now clear that a person’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 effectâ€"which seems to be at least partly 
> > > > > >regulated by opioid releaseâ€"suggesting the two phenomena 
> > > > > >have distinct mechanisms.
> > > > > >â€Å"Even if placebo and nocebo are on a continuum of 
> > > > > >expectation, different mechanisms kick in at different points along 
> > > > > >that continuum,†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.9ʉہ"It was a really risky 
> > > > > >experiment,†says Kaptchuk. â€Å"We were really 
> > > > > >surprised. We couldn’t believe it, 
> > > > > >actually.â€
> > > > > >The biochemical and physiological discoveries about nocebo have made 
> > > > > >the phenomenon more credible in the medical community. â€Å
> > > > > >"These brain measures provide objective evidence on the physical 
> > > > > >system implementing these squishy, fuzzy changes in emotion and 
> > > > > >expectation,†says Wager.
> > > > > >Most nocebo research to date, however, focuses on basic mechanisms, 
> > > > > >not on how to deal with the phenomenon in the clinic. â€Å
> > > > > >"Translational research has been a stepchild in scientific 
> > > > > >investigations of this phenomenon,†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 â€Å"side effects are not anticipated beyond 
> > > > > >occasional gastrointestinal irritation and, rarely, skin 
> > > > > >rash.†At the third center, patients’ 
> > > > > >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, â€Å"First, 
> > > > > >do no harm,†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 
> > > > > >the American 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 effectsâ€"those that are not a direct 
> > > > > >result of the pharmacological action of the 
> > > > > >drugâ€"including headache, nausea, and fatigue.
> > > > > >Nocebo is at least as important as the placebo effect and may be 
> > > > > >more widespread.â€"­ Ted 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. â€Å"I certainly 
> > > > > >don’t think that we should be rethinking whether 
> > > > > >informed consent should be a basic norm in clinical 
> > > > > >practice,†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
> > > >
> > >
> > 
> >
>




------------------------------------

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