Homeopathic remedies as placebo alternatives — verification on the example of treatment of menopause-related vegetative and emotional disturbances

With the example of treatment of menopause-related vegetative and emotional disturbances, the author verifies the effectiveness of the use of Ignatia amara containing complex homeopathic remedies (IACCHR) as an alternative to placebo. Substantial improvement in psychological and psychosomatic symptoms was observed. Climacteric complaints diminished or disappeared completely in the majority of women (95.7% by patient evaluation and 96.2% by physician evaluation). Compared to standard pharmaceuticals, IACCHR treatment was tolerated better and lower risk of side effects was observed. The results obtained in this work indicate the significant therapeutic potential of this group of treatments, which is in line with the therapeutic effect of the placebo. Nevertheless, the showing of specific effects in pharmacological tests disqualifies the investigated treatments from use in a clinical trial in place of a placebo. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

A psychological model that integrates ethics in engineering education

Ethics has become an increasingly important issue within engineering as the profession has become progressively more complex. The need to integrate ethics into an engineering curriculum is well documented, as education does not often sufficiently prepare engineers for the ethical conflicts they experience. Recent research indicates that there is great diversity in the way institutions approach the problem of teaching ethics to undergraduate engineering students; some schools require students to take general ethics courses from philosophical or religious perspectives, while others integrate ethics in existing engineering courses. The purpose of this paper is to propose a method to implement the integration of ethics in engineering education that is pedagogically based on Kohlberg’s stage theory of moral development.     

Placebo and criminal law

This article considers issues concerning cases where the use of placebo is lawful or is not lawful under aspects of German criminal law. It will differentiate between cases of individual therapy and cases of supervised experiments within the scope of medical tests. Thereby, it reveals that a medication of placebo with regard to an individual patient seems to be lawful if there is no alternative possibility of a better treatment using a chemically effective medicine and if the limits of presumed consent are complied with. On the other hand, in the context of the supervised experiment, the assignment of a patient to a group treated with placebo is only lawful if the patient has been fully informed about the possibilities of a treatment and if the patient has given consent to it. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003. The author’s interests include International Criminal Law, Comparative Criminal Law and Philosophy of Law.     

The dilemma of ethics in engineering education

This paper briefly summarizes current thinking in engineering ethics education, argues that much of that ethical instruction runs the risk of being only superficially effective, and explores some of the underlying systemic barriers within academia that contribute to this result. This is not to criticize or discourage efforts to improve ethics instruction. Rather it is to point to some more fundamental problems that still must be addressed in order to realize the full potential of enhanced ethics instruction. Issues discussed will include: intellectual engagement versus emotional engagement; the gravitational pull of curricular structures; the nature of engineering faculty; and the “engineer-ization” of ethics. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

The placebo effect in popular culture

This paper gives an overview of the placebo effect in popular culture, especially as it pertains to the work of authors Patrick O’Brian and Sinclair Lewis. The beloved physician as placebo, and the clinician scientist as villain are themes that respectively inform the novels, The Hundred Days and Arrowsmith. Excerpts from the novels, and from film show how the placebo effect, and the randomized clinical trial, have emerged into popular culture, and evolved over time. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.     

The concept of placebo

This paper attempts to define the concept of placebo as it is used in the clinical context The author claims that X is a placebo if and only if X has such a property d_p, that whenever in a therapeutic situation T a stimulus S appears, then in attending conditions A, it will cause a beneficial reaction R in the patient. Formally, the same structure may be used to define any pharmacologically active drug. The main difference between the drug and a placebo is in the range of possible substitutions for X and the property d. For the active drug there is only one possible substitution for X and property d and it can be scientifically explained why, and how the drug works. In the case of a placebo a set of possible substitutions for X and d is open, and so far it is impossible to offer any scientifically valid explanation of the action mechanism of placebo.     

American pragmatism as a guide for professional ethical conduct for engineers

The ethical choices faced by engineers today are increasingly complex. Competing and conflicting ethical demands from clients, communities, employees, and personal objectives combine to suggest that engineers employ ethical approaches that are adaptive yet grounded in three concrete professional circumstances: first, that engineers apply unique professional skills in the service of a client, subject to protecting the public interest; second, that engineers advance the state of knowledge of their professional field through reflection, research, and sharing experience in journals and conferences, and third, that they develop new professionals by active mentoring. This paper examines five features of American pragmatism and suggests that its emphasis on specific, context-based ethical decision making can assist engineers in a postmodern setting. In particular, it considers the venues of interpersonal ethical choices, institutional ethical conflicts, and social choices that have ethical components. Pragmatism suggests that in such a complex ethical climate, there is a need for the co-evolution of judgment and action, for individual reflective judgment in particular situations, and for ceasing to search for a single, immutable principle for ethical choice. An earlier version of this paper was presented at the “Ethics and Social Responsibility in Engineering and Technology” meeting, New Orleans, 2003.     

Switching between spatial stimulus-response mappings: a developmental study of cognitive flexibility

Four different age groups (8-9-year-olds, 11-12-year-olds, 13-15-year-olds and young adults) performed a spatial rule-switch task in which the sorting rule had to be detected on the basis of feedback or on the basis of switch cues. Performance errors were examined on the basis of a recently introduced method of error scoring for the Wisconsin Card Sorting Task (WCST; Barcelo & Knight, 2002). This method allowed us to differentiate between errors due to failure-to-maintain-set (distraction errors) and errors due to failure-to-switch-set (perseverative errors). The anticipated age differences in performance errors were most pronounced for perseverative errors between 8-9 years and 11-12 years, but for distraction errors adult levels were not reached until 13-15 years. These findings were interpreted to support the notion that set switching and set maintenance follow distinct developmental trajectories.     

The necessity and the value of placebo

The use of placebo in clinical trials has been repeatedly challenged as being unacceptable from an ethical point of view. The present paper responds to this criticism by taking up the issue in the light of the pertinent provisions of the Helsinki Declaration. Examples from different therapeutic areas are given that highlight the importance of placebo in situations in which its use is acceptable according to the Declaration. Particular emphasis is given to the question of active control trials, which, under conditions of low assay sensitivity, may become an ethically less acceptable approach than the use of a placebo control. An earlier version of this paper was presented at an international conference, “Placebo: Its Action and Place in Health Research Today,” held in Warsaw, Poland on 12–13 April, 2003.