You come to me, your doctor, with a complaint, say the common cold. I charge you a lot of money, write you a prescription for Phosphorus 6C, send you to the pharmacy where you spend a further silly amount of money on sugar with concentrations of phosphorus ten thousand times less than the allowable concentration of arsenic in drinking water.
Next week I ring you to ask how things are going. You believe that you’re supposed to have improved. It would make you feel rather silly to have gone to all this trouble to get essentially the same result as your cold clearing up of its own accord. You would rather feel clever about your choice of doctors and your overall judgement. None of that is conscious, but it still plays a role in picking your verbal response. You say “Much improved, Doc, thanks! That thing you gave me worked wonders!”
In all other particulars—nasal secretions, immune response, number of sneezes, actual misery experienced—this episode has been identical to what would have transpired if, counterfactually, you had decided to “tough it” and allow the cold to run its course. (I may hedge my bets on the “actual misery experienced” measure, if there were a way to actually get a number for that; I think the first-order misery is the same, but possibly you feel better about feeling miserable, knowing that it’s soon going to pass.)
Do I understand it correctly that if small dozes of sugar could make a measurable change in nasal secretions, immune response, number of sneezes, etc., then the premise of this article would be wrong?
Or would you have an ad-hoc explanation e.g. that the patient is suppressing the sneezes to avoid social embarrassment? If yes, where exactly is the line between measurable things that patient can do for social reasons, and things that patient cannot do for social reasons? I think understanding this boundary could be useful (for example we would know which illness can be treated by social means and which can not).
Yes, the distinction I’m drawing is between outcome measures that reflect voluntary behaviours (which can therefore be strongly influenced by expectations and so on) and involuntary physiological responses.
I think the first-order misery is the same, but possibly you feel better about feeling miserable, knowing that it’s soon going to pass.
This strikes me as a confused way of thinking about the situation. If this is an important part of your model of what’s going on, can you expand on what you mean by phrases like “feeling miserable,” “feeling better”, and “first-order misery”? (If it’s not important to your model, feel free to ignore.)
You come to me, your doctor, with a complaint, say the common cold. I charge you a lot of money, write you a prescription for Phosphorus 6C, send you to the pharmacy where you spend a further silly amount of money on sugar with concentrations of phosphorus ten thousand times less than the allowable concentration of arsenic in drinking water.
Next week I ring you to ask how things are going. You believe that you’re supposed to have improved. It would make you feel rather silly to have gone to all this trouble to get essentially the same result as your cold clearing up of its own accord. You would rather feel clever about your choice of doctors and your overall judgement. None of that is conscious, but it still plays a role in picking your verbal response. You say “Much improved, Doc, thanks! That thing you gave me worked wonders!”
In all other particulars—nasal secretions, immune response, number of sneezes, actual misery experienced—this episode has been identical to what would have transpired if, counterfactually, you had decided to “tough it” and allow the cold to run its course. (I may hedge my bets on the “actual misery experienced” measure, if there were a way to actually get a number for that; I think the first-order misery is the same, but possibly you feel better about feeling miserable, knowing that it’s soon going to pass.)
Do I understand it correctly that if small dozes of sugar could make a measurable change in nasal secretions, immune response, number of sneezes, etc., then the premise of this article would be wrong?
Or would you have an ad-hoc explanation e.g. that the patient is suppressing the sneezes to avoid social embarrassment? If yes, where exactly is the line between measurable things that patient can do for social reasons, and things that patient cannot do for social reasons? I think understanding this boundary could be useful (for example we would know which illness can be treated by social means and which can not).
Yes, the distinction I’m drawing is between outcome measures that reflect voluntary behaviours (which can therefore be strongly influenced by expectations and so on) and involuntary physiological responses.
This strikes me as a confused way of thinking about the situation. If this is an important part of your model of what’s going on, can you expand on what you mean by phrases like “feeling miserable,” “feeling better”, and “first-order misery”? (If it’s not important to your model, feel free to ignore.)