Thanks for all your input, I think I will give the copper insoles a miss and advise the client not to waste her money
Returns us to the old dilemma with placebos.
We know that the placebo effect can reduce pain, reduce blood pressure, stress, etc etc. RA is a multifactoral condition and some elements may in fact be improved with the use of a good placebo to reduce these factors. Therefore, paradoxically, it is possible that an intervention with no more actual physical effect than drinking rainwater might actually have a real theraputic effect
However a huge part of the placebo effect is the contact with the clinician and the whole medical drama played out in your clinic. For this to work they need to beleive that YOU beleive that the wretched things work.
This leads you to three options.
If you say that the copper insoles WILL help her RA because of magnetic vibrations in leylines of chi or some such tosh, you will, in a sense, be lying to your patient, undermining the Clinican - patient trust and behaving not altogether ethically. However there is a chance that via the placebo effect you will affect a genuine improvement of symptoms. Meaning you lied... but were proved right anyway. Bit like telling someone its safe to jump off a cliff when you did'nt know if there was a safty net or not. You might be right. But you don't know that you are!
If, conversly, you tell the truth, which is that they only work if she THINKS that it will and that she would get as much genuine medicine with them as a bit of tinfoil as with a £20 (or however much) bit of copper you will be behaving honestly, ethically, and observing the standards of informed consent which patients are entitled to. You might also be denying them genuine improvement of their symptoms not available through any other modalities!
The third option is to base your beleif that they work on some very, very dodgy science and deny yourself access to any evidence or argument which might damage your self fulfilling beleif in the placebo you are selling. This option gives you the means to offer the effective placebo without comprimising your morals... however it requires a degree of self control to not actually question what you are doing lest you find answers which disturb you. It also explains why some alternative practitioners get angry when challenged (if you are trying to avoid thinking about something its intensly annoying when people shout it at you).
The placebo paradox. Gotta love it.
Of course option three is no longer available to you without hypnosis induced amnesia of anything you may have learned here. Sorry. Its also never a trick i could master.
Option one might work if you can stomach the initial deception. I could never cope with that either.
Option two is the one i've always gone with, with the addition that i can occasionally bring myself to send the patient to someone who does option 3. Morally flacid, to empower somebody else to offer the velvet lies i choked on, but there you go.
So contestant number one (or anyone else jogging along), which of out three batchelors are you going to pick?