- Tapa blanda: 182 páginas
- Editor: Cambridge University Press (17 de octubre de 2002)
- Colección: Cambridge Studies in Medical Anthropology
- Idioma: Inglés
- ISBN-10: 9780521000871
- ISBN-13: 978-0521000871
- ASIN: 0521000874
- Clasificación en los más vendidos de Amazon: nº919.482 en Libros en idiomas extranjeros (Ver el Top 100 en Libros en idiomas extranjeros)
- Ver el Índice completo
Meaning, Medicine and the 'Placebo Effect' (Cambridge Studies in Medical Anthropology) (Inglés) Tapa blanda – 17 oct 2002
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Descripción del producto
'This lively book conceptualises the complex construct of the meaning response in medicine while taking advantage of current research and newly developed ideas.' Focus on Alternative and Complementary Therapies
'Daniel Moerman's Meaning, Medicine and the 'Placebo Effect' is a lucid accessible look at the power doctors have to restore patients to health with placebos.' London Review of Books
'Daniel Moerman wrote a very readably book. in plain English he describes the otherwise mostly statistically stated outcomes of experiments … it makes some of its chapters very useful for introductory courses. The book is also very useful for everyone who needs to 'break' through the pharmaceutical paradigm … it is all in all a beautiful book …'. Medische Antropologie: Tijdschrift over Gezondheid en Cultuur
'… fascinating … entertaining and accessible … I would recommend it to anyone who knows that there is more to pharmacology than just pharmacology and would like to try to understand why.' Pharmaceutical Physician
'… [this] recent volume in the Cambridge Studies in Medical Anthropology series [is an] important contribution to the study of medicines, not only for medical anthropologists, but for anybody who wants to understand what medicines do and how they do what they do … it is a testament to the book's quality that it raised many unanswered questions.' Journal of Biosocial Science
'This slim, engagingly written book attempts to replace the concept of 'placebo effect' … with a related one, 'meaning effect' … The book's conversational and chatty writing style … appears designed to appeal to an undergraduate audience. … Whether or not one accepts 'the meaning effect' as a novel or useful concept, the book is worth a read, and read critically is likely to provoke good classroom discussion.' Journal of the royal Anthropological Institute
'The wealth of experiments reported in this book demonstrate that medicine effects healing in many more ways than through active pharmaceutical ingredients… informative and entertaining…' Journal of Biological Science
Reseña del editor
Daniel Moerman presents an innovative and enlightening discussion of human reaction to the meaning of medical treatment. Traditionally, the effectiveness of medical treatments is attributed to specific elements, such as drugs or surgical procedures, but many things happen in medicine which simply cannot be accounted for in this way. The same drug can work differently when presented in different colours; drugs with widely advertised names can work better than the same drug without the name; inert drugs (placebos, dummies) often have dramatic effects on people (the 'placebo effect'); and effects can vary hugely among different European countries where the 'same' medical condition is understood differently, or has different meanings. This is true for surgery as well as for internal medicine. This lively 2002 book reviews and analyses these matters in lucid, straightforward prose, guiding the reader through a very complex body of literature, leaving nothing unexplained but avoiding any over-simplification.Ver Descripción del producto
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Bruce Barrett MD PhD
Department of Family Medicine
University of Wisconsin - Madison
It is because of our beliefs and the meaning we assocate with a placebo that determines its effectiveness. Despite this simple formula for determining who will respond to a placebo, it is not a very good predictor for a given individual at a given time. Studies show that there is no method to determine which individuals will respond to a placebo. Attempts have been made to remove placebo responders from studies. Occasionally, researchers will conduct a precursor trial run with a completely unrelated substance to indentify those who might respond to a placebo in an effort to cull these responders from the "real study". These attempts have been futile.
No reliable indicators have ever been found that identify individual placebo responders. In fact, a person who responds to a placebo in one study has no increased likely hood of responding to a placebo in subsequent studies. More remarkably, if one eliminates the approximately one third of the populace who initially respond to a given placebo, the remaining group will contain about the same proportion of responders in subsequent studies.
Moerman never makes the connection between these facts and the parallels to natual physical laws at the quantum level. And though they might be only coincidental, I think it worth the comparisons.
Note that a placebo has no causal effect, but instead it is meaning that determines the "effect" of a placebo. The late physicist David Bohm asserted that the entire universe is organized at all levels according to meaning. If this is true, then it substantiates Moerman's claim that meaning is operating at the macro level. But the similarites to physical law don't end here.
Moerman observed that when placebo responders are eliminated from a group, the same statistical relationships hold for the remainder of the group--approximately one third of the remaining group will still be responders in the next study.
Simlarities can be drawn with quantum processes such as the jump of the electron in orbit around the nucleus of an atom or the well-known process of nuclear decay. If one knows the half-life of a mass, it is possible to calculate exacly what proportion of the substance will remain after a given amount of time, yet nothng can be said about the transmutaion of any given atom. Divide the mass into two portions, and the half-life of each portion remains the same. As Moerman has shown this is exacly what we witness in placebo studies. It is possible to calculate statistically how many in a group will respond, but nothing can be said about which specific individuals will respond. In both cases, whether dealing with the placebo responders or nuclear decay, the process is determinate for the whole, but indeterminate for the individual person or particle. I have previously described this as a law--"nature conserves meaning".
Moerman documents many studies involving placebos from around the world. He notes that cultural differences, knowledge, and the practitioner all statistically contribute to the meaning response. In particular, it has been demonstrated that the character and personality of the physician has more to do with the outcome of placebo studies than the make up of the patient. Moerman contends that a positive and upbeat clinician or doctor transmits subltle cues to the patient making for a more positive outcome. He states that it is what the doctor "knows" that is important. If the doctor believes his patient has a possibility of getting a powerful drug, patients will do better than if he knows they will only be getting a placebo. The conclusion is sound, but the mechanism, I believe is dubious. I'm doubtful that some sort of "subtle" cues are passed onto the patient in such a consistent mannner. I wonder if it is reasonable once again to find the answer in physical law.
In the famous "double-slit" or "two-hole" experiments, it has been demonstrated that an "observer" is not necessary to change the behavior of particles. In fact, it is the mere possibility that the path or route of the particle can be determined at some point in the future that determines the outcome of the experiment. In experiments done by Marlan Scully at the Universtity of California at Berkeley it was found that it is our knowledge that determines the behavior of particles
"...It is our "potential" knowledge of the quantum system , not our actual knowledge that helps decide the outcome" (Davis, 1996).
Of course these associations with quantum processes are merely conjecture.
Daniel Moerman's book is well documented and it is obvious that much research went into this publication. If one wants a sound understanding of the placebo effect, or the "meaning response", this book is the one to read. Well done.
This book review by David Kreiter, author of "Quantum Reality: a New Philosophical Perspective".
All patients should read this book before, during and after visits to doctors. Psychologists like myself get important reminders about the mind body drive towards health and need to be reminded of it.
Altogether a great read, full of interesting facts and ideas
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