Lies, Placebos and Prayer: Bad Medicine as "Good" News

An NPR story on the medical effects of prayer has elicited an interesting colloquy among bloggers of the Reality Based Community. Michael O'Hare (from whose post you can link back to the others) makes what for me is the key point:

Prayer for diabetic shock may occasionally have effected a cure. But therapy directed physically at blood sugar levels is a much better bet, almost infinitely better, to the point that not dialing 911 for a comatose child is properly dealt with by the courts as involuntary manslaughter, especially after several hours of prayer not doing the job and the child getting worse.

There's an ocean of difference between a delicate, hard-to-observe, ephemeral effect that might lead to real scientific advance but will probably come to nothing, and treatments and practices that can be shown again and again to have big useful effects. It's cruel to describe the former in a news context so that it might be confused with the latter.

He also makes (in the same post) a nice point about the use and misuse of lies for life:

[P]lacebos of all types raise a perplexing issue for the health system that I have never seen examined. We can't just put them aside, because they do work sometimes, and sometimes when we have nothing else to offer. But they only work to the extent that we lie about them; a hospital that uses placebo treatment whenever it might help should have a sign over the door saying "placebo treatments are never used in this facility" and the health authorities must conspire never to uncover the scandal of this coverup.

But doing this as policy is an intermediate Russian doll; every context outside it has to maintain the same lie; one can easily imagine this leading to a tangled mess of unaccountable mendacity "for our own good" that ensnares an army, for example, to lie about Pat Tillman. If it's OK for us to believe wrong things to maintain certain medical efficacy, is it OK for us to believe wrong things to maintain military effectiveness?

I'd just note that the argument applies beyond the narrow context of social policy. While "[t]he falseness of a judgment is for us not necessarily an objection to a judgment," chances are still high that upon any invitation to believe a falsehood, we should want to decline, because any method you want to cook up for incorporating "healthy" fictions into our lives threatens to degenerate into incontinent, debilitating forms of dishonesty.