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  •                                  NETFUTURE
                        Technology and Human Responsibility
    Issue #93      A Publication of The Nature Institute       August 19, 1999
                Editor:  Stephen L. Talbott (stevet@netfuture.org)
                         On the Web: http://netfuture.org
         You may redistribute this newsletter for noncommercial purposes.
    NETFUTURE is a reader-supported publication.
    Quotes and Provocations
       Fear of Healing
       Is High School Dispensable?
       Bhutan and Fiji: The Elusive Influences of Television
    The Columbine Shootings (Stephen L. Talbott)
       Why television violence matters
    Announcements and Resources
       Waldorf Education Goes High-Profile
       Information Appliances May Prove More Frustrating Than You Think
       A Down Home Newsletter from Maine
    About this newsletter
                             QUOTES AND PROVOCATIONS
    Fear of Healing
    Just as I was publishing my commentary on alternative medicine and the
    placebo effect in NF #88, an article appeared in Science magazine (April
    9, 1999) entitled "Can the Placebo Be the Cure?"  The author, Martin
    Enserink, tells how the placebo effect "bedevils" antidepressant drug
    trials, posing, for drug developers, "an occupational hazard that masks
    the effects of potentially useful compounds".  "But", the article goes on,
    "there's more to it than that":
       Some psychiatrists and clinical psychologists are fascinated by the
       power of the placebo effect, viewing it not as a problem but as a
       source of insight into mental health.  And a few ... go further,
       challenging the scientific basis of much of the multibillion-dollar
       market for antidepressant drugs:  They argue that many compounds, even
       those with good scientific pedigrees, may be little more than
       sophisticated placebos themselves".
    Enserink cites a study suggesting that 75% of the effectiveness of
    antidepressants is owing to the placebo effect.  Moreover, the researchers
    who conducted the study, Irving Kirsch and Guy Saperstein, argue that even
    the remaining 25% may be little more than a disguised placebo effect.
    This is because as many as 80% of the participants in a "double-blind"
    study can guess correctly whether they're taking the "real" drug or the
    placebo, based on the presence or absence of side effects.  So the
    expectation of improvement is greater among the drug group, accentuating
    the placebo effect in that group.  (This is presumably why Prozac, a drug
    advertised as having few side effects, has proven most effective where the
    side effects are greatest.)
    The May 7 issue of Science contained a number of follow-up letters, none
    of which disputed the substantial role of the placebo effect.  One writer
    remarked that "it is difficult to find such a reliable phenomeno