False hope is actually worse

[HansMustermann]

http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1359

Short version: Turns out that giving chronically ill people false hope actually results in more unhappiness than just accepting the facts.

I'm bringing this up in "Religion and Philosophy" because basically that's the rationalization I keep hearing for religion. Basically, "yeah, well, even if you think it's bogus, if it gives people hope and makes them a little happier, why not let them keep their illusions?" And actually most often not formulated with an "if" there, but as if it were an undisputable fact that false hope _is_ making people happier.

Except in this study it turns out that false hope actually made people unhappier. The group which accepted the truth just moved on with their lives and didn't have to think about their misfortune half as much as the group that spent their life waiting for the miracle cure to happen to them.

Can it be that the comfy illusions provided by religion are actually just the same? Can it be that someone who doesn't spend their life thinking of death, and on whether they collected enough brownie points for salvation yet, is actually happier? Just food for thought.

[Third Eye Open]

So now we are going to let some scientist tell us what makes us happy? This is America, and people can choose to believe what they want! Of course convincing people that their beliefs are wrong makes people less happy afterword, if they stick to their convictions they will stay happy!

[Hux]

Having worked for years in medicine and patient care, I can remember a time when doctors used to consider if they should give a patient all bad news, based upon whether they thought the patient could take it. Consequently the family would know the full outcome and the patient harboured thoughts of recovery. This resulted in a lot of heartache for families and false hope for the patient. Eventually they would realise they were getting no better, indeed getting worse -and they were invariably resentful.

Nowadays, Doctors tell all patients diagnosis and prognosis and, although there is obvious fear, I never met anyone who didn't manage to face the future. Most gave over their time to putting things in order, putting things right and - in twenty years, I never heard one terminal person ask for a visit from the hospital padre. The Catholics always got a visit from the Priest however, in which case they knew they were completely screwed.

False hope is no hope at all. I mean what can a Priest say to you? You're going to die soon but you'll meet Jesus? or, "No you'll be grand"? Either way that's a horrible lie to tell someone who's dying.

[HansMustermann]

Unhappier in the short run, maybe, but in the long run I'm not convinced.

And sometimes they make others unhappy too. E.g., take this classic children's prayer:

Now I lay me down to sleep,
I pray the Lord my soul to keep;
Should I die before I wake,
I pray the Lord my soul to take.

What kind of idiot would make a child think about their own (possibly imminent) death every evening? I know that as an atheist I wouldn't come to the idea of reminding any children every evening that they might die before they wake.

Heck, the thought doesn't even come naturally about myself. If I die before I wake, I figure it can't be too painful or I'd wake up. Not a bad way to go, eh? And with that mundane, non-theist thought I can't say I've ever felt a need to think about death when I go to bed.

But it seems to me like the adults punish themselves too. A constant theme for fundies seems to be, basically, how prepared are they for when they pass that final gate. It's a life spent thinking of death and preparing for death. I can't see any reason why someone who's just accepted reality for what it is, would put themselves through the same constant prodding an aching tooth. I, for example, figure that when I die, I'll be as prepared for death as biologically required to, you know, actually die. And there's no collecting brownie points that will make any difference on that day, so no point worrying about that.

[Hux]

That prayer is one of the most obnoxious and foulest things I have ever heard. Typically Christian.

[Mark6]

What kind of idiot sadist would make a child think about their own (possibly imminent) death every evening?
Error in your post corrected

[JoeTheJuggler]

So now we are going to let some scientist tell us what makes us happy? This is America, and people can choose to believe what they want! Of course convincing people that their beliefs are wrong makes people less happy afterword, if they stick to their convictions they will stay happy!
And if you stay drunk or stoned (or psychotically deluded) you can be "happy". . .for an extremely limited meaning of "happy".

At any rate, the study didn't say we should let "some scientist tell us what makes us happy". It said that giving a seriously sick person false hope results in worse outcomes than being honest.

Since religion arguably deals in false hope, it could be argued that the study says we shouldn't let priests and such tell us what makes us happy. Even so, that's going pretty far beyond what the study says.

[sonofgloin]

And if you stay drunk or stoned (or psychotically deluded) you can be "happy". . .for an extremely limited meaning of "happy".

There are two realities, your and theirs, "psychotically deluded" or not reality is reality to the individual. Regarding the question of knowing or not knowing your fate, I had seen a documentary on a Jewish holocaust survivor who's entire family was murdered. When asked whether it was better or worse to have known their fate in the long process of eviction, transport and eventually murder she pondered hard and said "I don't know if it is good or not to know your fate beforehand.

[Maia]

This is a fascinating discussion, and it may be true that false hope is worse is none at all, but I do have to point out that proof for the idea is not based on what the study actually seems to have said. I wish they had a link to the study itself, but they don't, so all we can go on is the summary provided. Two groups were compared: people who had reversible colostomies-- that is, ones that really weren't permanent -- and people who had non-reversible ones. The second group reported "feeling happier over the next six months."

But the problem is that the two groups cannot have been comparable and must, by logic, have been two qualitatively different groups of people. It would have absolutely 100% unimaginably unethical to tell people whose colostomies were really irreversible that they actually weren't, and vice versa (no ethics committee since Nuremberg would have come anywhere close to permitting it). This means that the two groups really did have two completely different types of colostomies, one reversible, one irreversible. One group knew all along that they were going to have exactly the opposite outcome from the other group, or at least had a real chance. No wonder they "contrasted their current life with the life they hoped to lead, and didn’t make the best of their current situation.” So it was incredibly misleading to stick on this article headline: "Research shows chronically ill might be happier if they gave up hope," because that's not at all what the study showed. The group with reversible colostomies had every logical reason for hope.

That being said, the discussion is going in an interesting direction anyway. :)

[HansMustermann]

Actually, no, the way I understand it, both were irreversible. One group was just given the false hope that it would be reversed at a later date, although no such thing was possible. They were just _told_ it's reversible. It actually wasn't.

[Gayle]

I'm having trouble interpreting the news article. Without the entire study, it doesn't make sense to me. In general, I agree with Maia's comments.

It seems beyond reason that patients who had undergone a colostomy would be randomly assigned to two groups: one group being told the colostomy was permanent; the other that it was temporary and reversible.

Telling a patient who has a permanent colostomy that it's temporary and reversible amounts to extreme malpractice. I can't imagine any hospital or university human subjects panel allowing such a study, not in the 21st Century.

If you have a permanent colostomy and know it, then you've reached a stage in your treatment where you get on with your life as best as you can. It would be healthy behavior to try to accept the situation and to do one's best to find as much happiness with life as possible. It would be healthy to have hope that your surgical treatment is over.

If you think you have a temporary colostomy, you're in the middle of treatment and you know you're going to face more surgery 6 or 8 or 12 weeks down the road. Is it healthy to feel happy happy happy about more surgery, about having to wait weeks or months to find out if you're going to be okay, about more major medical bills and risks of complications? You'd be nutty to hope that you won't be facing further surgery. Reversal of a colostomy is surgical. Sometimes major; sometimes a simpler procedure. But never easy.

If patients were randomly assigned regardless of their diagnosis, prognosis and need for further treatment, then it was a cruel study and its perpetrators deserve to be sued by the patients who were lied to. They deserve to lose their licenses to practice medicine. If the patients were given accurate information regarding their diagnosis, prognosis and treatment, then the two groups were not the same. Comparing them makes no sense.

Any way you look at it, it sounds like a really bad study that tells us nothing about hope and it's relationship to happiness.

[Maia]

Well, I searched and searched and just couldn't find that study. It was reportedly published in Health Psychology, but the most recent issue feed doesn't show it. (That journal can be found here. (http://psycnet.apa.org/journals/hea/28/4/)The study doesn't appear to be up on Pubmed yet. But I'd bet, well, a whole lot that the two groups had to be composed of reversible vs. nonreversible colostomies (because of The Nuremberg Code of Ethics (http://www.cirp.org/library/ethics/nuremberg/) and all of its sucessors, by which experimentation involving human subjects are governed. Every proposed experiment/study of that kind has to go before a review board (and through a university, there are absolutely no exceptions.)

That being said, it's easy to see why anybody would think otherwise from the way the article was written. What was the editor smoking that day??

[Gayle]

Here's a press release from the university of one of the researchers. It gives a little more information than the original article.

http://www.cmu.edu/news/archive/2009/November/nov2_happilyhopeless.shtml

[JoeTheJuggler]

There are two realities, your and theirs, "psychotically deluded" or not reality is reality to the individual.

I utterly disagree with the notion that each person can create his own reality. There's one reality, and everyone of us forms a mental model (or many mental models) of that reality. Some of these models (the deluded ones) are completely wrong, or at least vastly less accurate than others.

If someone has a hallucination it is not meaningful to say that the content of the hallucination was real. (In fact, that's pretty much what defines it as hallucination.)

[JoeTheJuggler]

Actually, no, the way I understand it, both were irreversible. One group was just given the false hope that it would be reversed at a later date, although no such thing was possible. They were just _told_ it's reversible. It actually wasn't.

That's the way I understood it also.

If it were the way Maia described it, it wouldn't be reasonable at all to say the study was about false hope.

ETA: I take it back. After watching the video with the press release, I think Maia is right. I think this wasn't really a study on false hope. If anything it seems to say that having a done deal (for better or worse) correlates with more happiness than not knowing yet (having real hope).

And I think it's going to be in November's issue of that journal (http://psycnet.apa.org/index.cfm?fa=browsePA.volumes&jcode=hea) which is not on their website yet.

[Beth]

What is the difference between false and real hope for a small probability occurance? Whether recovery from cancer (spontaneous remissions are not completely unheard of) or the belief that your garage band will someday make a best-selling record album, it is giving people false hope to encourage them about believing in the possibility that they will be one of the lucky ones? After all, the ones who give up hope and stop trying are guaranteed to never make that best selling album.

So, when the probablity of success is very low, how do you distinguish false hope from real hope?

[JoeTheJuggler]

What is the difference between false and real hope for a small probability occurance? <snip>

So, when the probablity of success is very low, how do you distinguish false hope from real hope?
In the study, the probability of reversal was not equally low for the two groups. So the hope given to the group who were told their condition might be reversible was real hope and not false hope.

ETA: And Maia was also right that if the study were conducted the way Hans and I both originally thought, there would have been very serious ethical problems with it.

[Beth]

In the study, the probability of reversal was not equally low for the two groups. So the hope given to the group who were told their condition might be reversible was real hope and not false hope.

ETA: And Maia was also right that if the study were conducted the way Hans and I both originally thought, there would have been very serious ethical problems with it.


I wasn't referring to the study, but simply to the term 'false hope' in general. How do you distinguish false hope from real hope?

[JoeTheJuggler]

I wasn't referring to the study, but simply to the term 'false hope' in general. How do you distinguish false hope from real hope?

False hope is when you are misled to think the probability of something good is greater than it actually is.

Even when I got my EMT license we were taught that. It's wrong to tell people they're going to be OK if you aren't confident that they're going to be OK.

[blobru]

What is the difference between false and real hope for a small probability occurance? Whether recovery from cancer (spontaneous remissions are not completely unheard of) or the belief that your garage band will someday make a best-selling record album, it is giving people false hope to encourage them about believing in the possibility that they will be one of the lucky ones? After all, the ones who give up hope and stop trying are guaranteed to never make that best selling album.

So, when the probablity of success is very low, how do you distinguish false hope from real hope?


False hope is giving a higher probability of success than there actually is: telling the cancer patient or garage band that they have good odds of 'success', when your informed estimate is they have bad odds, for example.

(as a macabre aside, it strikes me the odds are pretty good that there is a garage band somewhere called "cancer patient", with very bad odds of success).

[blobru]

This is a fascinating discussion, and it may be true that false hope is worse is none at all, but I do have to point out that proof for the idea is not based on what the study actually seems to have said. I wish they had a link to the study itself, but they don't, so all we can go on is the summary provided. Two groups were compared: people who had reversible colostomies-- that is, ones that really weren't permanent -- and people who had non-reversible ones. The second group reported "feeling happier over the next six months."

But the problem is that the two groups cannot have been comparable and must, by logic, have been two qualitatively different groups of people. It would have absolutely 100% unimaginably unethical to tell people whose colostomies were really irreversible that they actually weren't, and vice versa (no ethics committee since Nuremberg would have come anywhere close to permitting it). This means that the two groups really did have two completely different types of colostomies, one reversible, one irreversible. One group knew all along that they were going to have exactly the opposite outcome from the other group, or at least had a real chance. No wonder they "contrasted their current life with the life they hoped to lead, and didn’t make the best of their current situation.” So it was incredibly misleading to stick on this article headline: "Research shows chronically ill might be happier if they gave up hope," because that's not at all what the study showed. The group with reversible colostomies had every logical reason for hope.

That being said, the discussion is going in an interesting direction anyway. :)


Very nice analysis, Maia, and I'm glad the study wasn't as Mengelesque as the headline implied; however, I'm not sure that fact invalidates the conclusion. Even though there was no "false hope" group per se, if we assume the patients can't determine themselves whether they've had a reversible or an irreversible colostomy, then a group told they've had a reversible colostomy and which has had a reversible colostomy experiences the same thing that a group told they've had a reversible colostomy but which has had an irreversible colostomy would.

That is, the hope is the same for the person who has it. Whether the hope is true or false is known only to the person who gives it (obviously, everyone assumes his hope is true). So, assuming a distinction can be made and ethical considerations aside, any conclusion that can be drawn about hope should apply to both true hope and false hope (I hope).

[Maia]

Very nice analysis, Maia, and I'm glad the study wasn't as Mengelesque as the headline implied; however, I'm not sure that fact invalidates the conclusion. Even though there was no "false hope" group per se, if we assume the patients can't determine themselves whether they've had a reversible or an irreversible colostomy, then a group told they've had a reversible colostomy and which has had a reversible colostomy experiences the same thing that a group told they've had a reversible colostomy but which has had an irreversible colostomy would.

That is, the hope is the same for the person who has it. Whether the hope is true or false is known only to the person who gives it (obviously, everyone assumes his hope is true). So, assuming a distinction can be made and ethical considerations aside, any conclusion that can be drawn about hope should apply to both true hope and false hope (I hope).


Er... no, not in an actual study which is not being run by Neo-Nazis in the jungles of Bolivia or somewhere similar. Participants make informed decisions about the nature of their participation, including the information that they cannot be lied to about their medical condition. Ethics committees do not play around; no researcher could begin to get away with a stunt like that. The consequences would include prison sentences and huge fines for everyone involved. (The biggest infractions of ethics which researchers have perpetrated in recent years have actually involved incidents long before the committees gave their approval.) I don't know what everybody thinks scientists are getting away with doing in universities these days!!!

But the way the original article was written was so misleading, and almost all of the other articles I tracked down weren't a whole lot better. It's easy to come away with the distinct impression that researchers weren't obligated to be truthful
with their subjects. I'm not sure why such irresponsible reporting was published.

[blobru]

... But the way the original article was written was so misleading, and almost all of the other articles I tracked down weren't a whole lot better. It's easy to come away with the distinct impression that researchers weren't obligated to be truthful
with their subjects. I'm not sure why such irresponsible reporting was published.

Yes, it was misleading that way.

I'd guess the headline comes from the study's conclusion, which I'm inclined to agree with. For a group lied to about their medical condition would experience the same thing as a group told the truth; they would both have the same expectations, and behave in the same way, right up until their expectations are met, their hopes fulfilled -- or not.

[Beth]

False hope is when you are misled to think the probability of something good is greater than it actually is.

Even when I got my EMT license we were taught that. It's wrong to tell people they're going to be OK if you aren't confident that they're going to be OK.

False hope is giving a higher probability of success than there actually is: telling the cancer patient or garage band that they have good odds of 'success', when your informed estimate is they have bad odds, for example.

(as a macabre aside, it strikes me the odds are pretty good that there is a garage band somewhere called "cancer patient", with very bad odds of success).

Okay. That makes sense. Thanks.

[JoeTheJuggler]

Even though there was no "false hope" group per se, if we assume the patients can't determine themselves whether they've had a reversible or an irreversible colostomy, then a group told they've had a reversible colostomy and which has had a reversible colostomy experiences the same thing that a group told they've had a reversible colostomy but which has had an irreversible colostomy would.

For the sake of experimental design, though, the two groups were actually different other than in what they were told. (I understand your point that from the point of view of a subject in the reversible group, they wouldn't know the difference if they were actually irreversible but being lied to, but in fact they were different.) So not only was it not really about "false hope", it wasn't a very good design anyway. About all you can say is that people with irreversible colostomies were happier than those with colostomies that might be reversible.

ETA: That is, the two groups differed in other ways than just what they were told. The possibly reversible group was doubtlessly going in and out for more testing and such, while the irreversible group was adjusting to life with a colostomy.

I think the possible generalization is more about having to cope with a fait accompli vs. dealing with an unknown future. It's not really about what they were told, but the fact that the two groups have two very different things to deal with emotionally.

[godless dave]

There are two realities, your and theirs, "psychotically deluded" or not reality is reality to the individual.

There's only one reality. Our perceptions of it differ.

[blobru]

For the sake of experimental design, though, the two groups were actually different other than in what they were told. (I understand your point that from the point of view of a subject in the reversible group, they wouldn't know the difference if they were actually irreversible but being lied to, but in fact they were different.) So not only was it not really about "false hope", it wasn't a very good design anyway. About all you can say is that people with irreversible colostomies were happier than those with colostomies that might be reversible.

Yeah, it's really just a survey attached to regular colostomy treatment, for reasons of ethics Maia raised.

ETA: That is, the two groups differed in other ways than just what they were told. The possibly reversible group was doubtlessly going in and out for more testing and such, while the irreversible group was adjusting to life with a colostomy.

Maybe. If one group had significantly more doctor's check-ups in the six-month[?] window of the survey, that would confound the data; I expect more check-ups is stressful and depresses mood. I'm not sure that's the case, though, or if it is which group would need more check-ups (I might have guessed the irreversibles, as their surgery, presumably, was more invasive).

I think the possible generalization is more about having to cope with a fait accompli vs. dealing with an unknown future. It's not really about what they were told, but the fact that the two groups have two very different things to deal with emotionally.

Hmm... yet that still sounds close enough to "hope" (unknown future) vs. "no hope" (fait accompli) that I'm willing to... ponder their conclusions further*, let's say. :p

But false hope or not, I sure didn't expect the reversible group to be the unhappier after six months. Did you?
Ok, bag the colostomies. Imagine being sent to prison: in one scenario, I'll be let out after a year ('reversible' group); in the other, I'm sentenced to life (irreversible). If somebody had told me that according to some psych study I'd probably, after six months, be happier as a prisoner with no hope of release than one serving a year in jail, I'd have thought she was gassed. Yet that's what the conclusion implies. If valid, it's quite surprising to me (have to admit I barely skimmed it -- there may be other reasons for doubt).

*ETA: & having pondered the conclusions further, I think uncertainty surrounding the reversal surgery could play a large part in the reversibles' anxiety and unhappiness, moreso than false hope: they might be worried about ending up in the same state as the irreversibles after a failed surgery, while the irreversibles have already accepted they are in that state, and are adapting to it. In that case, unknown future vs. fait accompli would be the better explanation, as you suggested.

[HansMustermann]

Actually, it doesn't stretch my imagination too much to believe that for that year in jail you'd be unhappier. I think most of us do at most a half-arsed job of adapting to stuff that's temporary and ultimately of no consequence in the long run. Be it a temp job or a prison term or whatever.

Basically think of it like this: imagine you got a 2 week temp job in a different town, and you know that there was no way it'll turn into a permanent job. I'm guessing that you wouldn't bother much making friends, knowing the neighbours, or finding much motivation in that job. It's just something to put up with for 2 weeks, not something you even try to adapt to.

I've actually been through a situation vaguely like that once, helping with a project in another city.

So, yes, probably the guy who's in jail for life, will get more used to the idea and live life as best he can in that prison. Whereas the guy who's there only for half a year, will just count days until release and just contrast his situation to what he's expecting.

[Maia]

I found a study (http://www.ncbi.nlm.nih.gov/pubmed/8918429)which might suggest that a lot of patients with reversible colostomies actually have a prognosis that may be worse in the long run and a greater likelihood of medical complications and morbidity than those with irreversible ones, except for those in a very particular group, such as patients who've had an ostomy for diverticulitis. (http://www.ncbi.nlm.nih.gov/pubmed/15529854?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=3&log$=relatedarticles&logdbfrom=pubmed)For some weird reason, people who'd had a colostomy for cancer found it easier to adjust than those who'd had one for other reasons in one very large study. (http://www.ncbi.nlm.nih.gov/pubmed/17196990?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_MultiItemSupl.Pubmed_TitleSearch&linkpos=2&log$=pmtitlesearch4) A well-designed meta-study on perceived quality of life in cancer patients who had permanent colostomies found it impossible to conclude how large or small the negative effect actually was. (http://www.ncbi.nlm.nih.gov/pubmed/15266529?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsP anel.Pubmed_SingleItemSupl.Pubmed_Discovery_RA&linkpos=5&log$=relatedreviews&logdbfrom=pubmed)

All in all, I do have to seriously wonder how comparable the two groups in the original study actually were. One idea that occurred to me is that the group with the irreversible colostomies might have been a lot more likely to have a condition like colon cancer. Once they had colostomies, at least they knew that they had a good chance of becoming long-term survivors. On the other hand, the group with potentially reversible colostomies might have had conditions that they knew could change rapidly for the worse and were unstable.

In that context, it would make a lot of sense--much more, in fact-- for possible hope to be worse than none of all, because the best could just as easily have turned into the worst (and if this was the case, for a significant number of these people, it probably did.) It would have been kind of like being assigned to one of two groups. One was told that something bad had happened to them, but that they were all very likely to at least survive it. The other was told that they might have the best possible outcome, but that they also might have the worst, and that if so, it would be much worse than what happened to the people in the other group. It puts a different spin on the idea of the value of hope!

[HansMustermann]

You mean sorta like how Christianity tells people that they could get the best possible outcome or they can get something even worse? :p

[blobru]

... ... In that context, it would make a lot of sense--much more, in fact-- for possible hope to be worse than none of all, because the best could just as easily have turned into the worst (and if this was the case, for a significant number of these people, it probably did.) It would have been kind of like being assigned to one of two groups. One was told that something bad had happened to them, but that they were all very likely to at least survive it. The other was told that they might have the best possible outcome, but that they also might have the worst, and that if so, it would be much worse than what happened to the people in the other group. It puts a different spin on the idea of the value of hope!

Good work again, Maia. :)

I've come over to your and Joe's position: the groups in the study are too disparate to form any conclusions on what hopes they have and how that is affecting their happiness. It may very well be, as in Hans' take on the jail scenario, that temporary hope is worse than acceptance for happiness. But we certainly can't conclude that from this misleading study.

[JoeTheJuggler]

All in all, I do have to seriously wonder how comparable the two groups in the original study actually were.

Yup. Apples and oranges.

One idea that occurred to me is that the group with the irreversible colostomies might have been a lot more likely to have a condition like colon cancer. Once they had colostomies, at least they knew that they had a good chance of becoming long-term survivors. On the other hand, the group with potentially reversible colostomies might have had conditions that they knew could change rapidly for the worse and were unstable.

In that context, it would make a lot of sense--much more, in fact-- for possible hope to be worse than none of all, because the best could just as easily have turned into the worst (and if this was the case, for a significant number of these people, it probably did.)
That's similar to the idea I've been pushing. That just having a done deal is easier to handle emotionally than the unknown. Although you're pointing out that in this study the real possibility of an even worse end result still hangs over the reversible group.

I was trying to think of possible studies that could get at my idea. Maybe comparing a post-mastectomy breast cancer group to a group with breast cancer still trying other treatment options that may or may not end up getting mastectomies.

Or spinal cord injuries in two groups: those who are paralyzed and know it's permanent compared to those who are paralyzed but don't know if it will be permanent. (That is, there's no worse outcome looming, but there is the chance of regaining function.)

The hypothesis I'd like to test is that the first group in each of these would have some degree of happiness (or maybe being at peace or sense of closure) than the second groups.

[Malerin]

I looked but couldn't find a study concerning whether lying about the severity of an illness (e.g., cancer) increases the chances for recovery. The theory being, someone who is told they have almost no hope of recovery might assume the disease has already won and give up. The same person, if told they have an 80% chance of recovery, might be more optimistic, less stressed out, and in a better frame of mind to fight the disease.

[JoeTheJuggler]

I looked but couldn't find a study concerning whether lying about the severity of an illness (e.g., cancer) increases the chances for recovery.
Probably because such an experiment would be unethical and no reputable journal would publish the results.

However, one of those prayer studies did something kind of similar. The group of people who were told they were being prayed for had worse outcomes. I don't remember if it was a significant difference, but the speculation was that it was sort of an anti-placebo. "If they're praying for me, I must be at death's door!" Then a bit of self-fulfilling prophecy (maybe related to the anxiety and stress).

[Malerin]

Probably because such an experiment would be unethical and no reputable journal would publish the results.

However, one of those prayer studies did something kind of similar. The group of people who were told they were being prayed for had worse outcomes. I don't remember if it was a significant difference, but the speculation was that it was sort of an anti-placebo. "If they're praying for me, I must be at death's door!" Then a bit of self-fulfilling prophecy (maybe related to the anxiety and stress).

I remember reading a long time ago that in Japan, doctors can lie to patients if they think it will increase their chances of recovery.

Are there any single-blind placebo trials, or are they all double-blind?

[Nihilus]

Relating this article to the espousal of metaphysical beliefs isn't quite wholly congruent. What contributes to the issue in medical conditions is the fact that it's not really possible to delude one's self away from biological reality. Meaning, the physical status is clear and obvious to the person for whom it is in dire status...which cannot be reconciled with the prognosis and hope of it getting better.

With religion and spirituality, however, the barometer by which the individual determines if they're "getting better" is purely self-created. Furthermore, the process of yielding to metaphysical belief comes with the predisposition to positive interpretation, permitting for continual positive feedback in most cases.

[JoeTheJuggler]

I remember reading a long time ago that in Japan, doctors can lie to patients if they think it will increase their chances of recovery.
It definitely not OK here. (And frankly I'm skeptical that's true in Japan.) Legally, a patient can't give informed consent if he is misinformed.

Are there any single-blind placebo trials, or are they all double-blind?
People who participate in double blind placebo controlled trials are informed that they're participating in double blind placebo controlled trials. They are informed that they might be getting a placebo or a real treatment, but that neither they nor the people administering the drug or measuring the outcome know which group they're in.

That is not at all the same as being lied to about your prognosis.

[Malerin]

It definitely not OK here. (And frankly I'm skeptical that's true in Japan.) Legally, a patient can't give informed consent if he is misinformed.

I tried to verify, but couldn't find anything


People who participate in double blind placebo controlled trials are informed that they're participating in double blind placebo controlled trials. They are informed that they might be getting a placebo or a real treatment, but that neither they nor the people administering the drug or measuring the outcome know which group they're in.

That is not at all the same as being lied to about your prognosis.

I know, that's why I asked about single-blind studies. In those typed of studies, you are being lied to (or at least information if being withheld).

[JoeTheJuggler]

I know, that's why I asked about single-blind studies. In those typed of studies, you are being lied to (or at least information if being withheld).
If you participate in a single blind study you are told (before you agree) that you might get the treatment and you might get a placebo. In a single blind study, the people giving it to you (and/or taking the outcome measurements) know which group you're in.

This is not at all comparable to lying to a patient about his or her prognosis.

[Malerin]

If you participate in a single blind study you are told (before you agree) that you might get the treatment and you might get a placebo. In a single blind study, the people giving it to you (and/or taking the outcome measurements) know which group you're in.

This is not at all comparable to lying to a patient about his or her prognosis.

It's deliberate withholding of information about a treatment. How is that different than deliberately not telling a patient about the very low odds of recovery from a disease?

[PirateDaveZOMG]

I remember reading a long time ago that in Japan, doctors can lie to patients if they think it will increase their chances of recovery?

http://www.nytimes.com/1995/02/25/world/tokyo-journal-when-doctor-won-t-tell-cancer-patient-the-truth.html
New York Times Article; February 25, 1995
"A 50-year-old woman named Kazuko Makino was told that she had gallstones, even though her doctor suspected gallbladder cancer. The doctor recommended surgery, but Mrs. Makino was a nurse and decided that she did not need an operation to remove her "gallstones."

The cancer spread, and Mrs. Makino died. Her family sued the hospital for malpractice, but a court rejected the claim, ruling in a landmark case in 1989 that doctors need not tell cancer patients their true condition."

http://www.springerlink.com/content/483424h1k1g07021/
Article by a surgeon with the University of Tokyo; 1991

http://www3.interscience.wiley.com/journal/119090789/abstract
No full text, just a summary of a paper contained in Nursing & Health Sciences, which seems to be THE tome for nursing used in Asia, site is a pay-site in order to obtain full digital texts; No specific publishing date given, though the first Issue seems to have been published in 1999, and the paper in question is from Issue 3, with Issue 3 being 'Published Online in 2002' according to the site

There seems to be little to indicate this is still practiced though.

[Maia]

Originally Posted by JoeTheJuggler
If you participate in a single blind study you are told (before you agree) that you might get the treatment and you might get a placebo. In a single blind study, the people giving it to you (and/or taking the outcome measurements) know which group you're in.

This is not at all comparable to lying to a patient about his or her prognosis.
It's deliberate withholding of information about a treatment. How is that different than deliberately not telling a patient about the very low odds of recovery from a disease?


Completely different. The reason is that single-blind studies are performed in situations where double-blind studies are not practical or possible, where the researchers cannot be blind to the nature of treatment. Also, we might as well say in that context that double-blind studies are even worse, because nobody involved knows which group is receiving what. But this is why there are very specific ethical guidelines about experiments and studies involving human subjects, so it's an important question to ask.