Intercessory Prayer for Healing: Looking at the Studies
Intercessory Prayer for Healing: Looking at the Studies
By Dónal P. O'Mathùna, PhD
Dr. O'Mathùna is Senior Lecturer in Ethics, Decision-Making and Evidence, School of Nursing, Dublin City University, Ireland; he reports no financial relationship to this field of study.
In september 2010, the most recent study of intercessory prayer was published in the Southern Medical Journal.1 The researchers suggested that the key to prayer's effectiveness was proximity between the person praying and the one prayed for. The study followed 24 Mozambican subjects who received intercessory prayer for hearing and/or vision problems. Although significant improvements were reported, the study did not have a control group, it was not double-blinded, and challenging field conditions led to deviations from the protocol.
This study is the latest is a series of scientific investigations of prayer that can be traced back to the Irish physicist John Tyndall.2 In 1872, Tyndall proposed that all Christians should pray for the patients of one particular ward or hospital for at least 3 years. Skeptical of Christianity, he believed that patient outcomes would be no better in that hospital compared to other hospitals and this investigation would provide scientific evidence that prayer is ineffective.
The experiment was never conducted, but it generated controversy on both sides of the Atlantic and has become known as the Prayer-Gauge Debate.3 Francis Galton, a cousin of Charles Darwin, noted that people pray frequently for clergy and royalty. He suggested that the records be examined to see whether those receiving these prayers lived longer, happier lives. He found that those prayed for lived shorter lives than "less noble" professionals. Galton believed this was evidence that prayer doesn't work.
The topic received little attention for several decades until 1988, when the Southern Medical Journal published a study by Randolph Byrd.4 This high-quality controlled trial enrolled coronary care unit patients and randomized them to either control or daily prayer. This was the first of several large randomized controlled trials (RCTs) that have been published over the past two decades.
Part of the reason for these studies may be that in surveys of complementary and alternative medicine, prayer consistently tops the lists. Prayer was the most frequently used therapy in the three large surveys carried out by David Eisenberg and colleagues at Harvard Medical School. The proportion of U.S. adults using prayer was 25%, 35%, and 45% in 1990, 1997, and 2002, respectively.5 The most recent survey, published in 2005, collected more detailed information on prayer. Although in general prayer was the most popular "therapy," used by 45% of respondents, 43% prayed for their own health (making it the second most popular therapy), 24.2% had others praying for their health (the third most popular therapy), and 9.6% participated in a prayer group (the sixth most popular therapy). Given such prevalent use, it would make sense that researchers try to establish whether or not it is effective. Clinicians should be aware of this evidence so they can discuss it with patients. Given that prayer often is a deeply personal practice, patients may want to discuss the implications of this research for their own health and well-being.
Searching the Literature
Viewing prayer as a therapy is problematic for some. Prayer can be an expression of someone's personal relationship with God, not a therapy to be used only when needed. Such contemplative prayer is different from what usually is tested in scientific studies.6 Intercessory prayer is more amenable to research because the person praying is usually different from the one prayed for.
Controlled studies of intercessory prayer for health and healing in humans will be reviewed here. A total of 28 published trials of intercessory prayer were located. Although most studies have examined various types of Christian prayer, other practices have been included. These include Jewish, Buddhist, and various esoteric practices. These studies can be divided into three general groups:2
Small studies examining physical conditions (eight studies)
Studies of psychological conditions (six studies)
Higher quality studies of physical conditions (14 studies)
It would be challenging to combine the results of these studies due to their different designs and outcomes. Rather than discuss all the studies, two sub-groups will be examined as characteristic of the whole group. The first includes some of the best studies, while the second includes the worst.
Randomized Studies with Cardiac Patients
A number of larger RCTs have been published in recent years. The first of these, by Randolph Byrd, randomized 393 coronary care unit patients to either control or daily prayer from "born-again" Christians.4 Between three and seven people prayed for each patient for a rapid recovery and prevention of both complications and death. No significant differences between the two groups were found on those outcomes. Twenty-six other medical outcomes were measured, with the prayer group having significantly better results in six. A tool for ranking patients' overall outcome was developed (but not validated), and showed the prayed for patients did significantly better (P < 0.01).
Byrd's study was replicated in 1999 with 990 coronary care unit patients.7 Those randomized to the prayer group received Christian prayer for 28 days. Thirty-five medical outcomes were examined, with no significant differences on any individual measure. Using Byrd's tool no significant differences in overall outcome were found, but a tool developed (but not validated) by these researchers found significant improvements (P = 0.04). The prayer group scored 11% better than the control group, but the researchers questioned the clinical significance of this.
A third RCT was published in 2001.8 As 799 patients were being discharged from a hospital coronary care unit, they were randomly assigned to receive prayer or not. People from religious and community groups volunteered to pray for each patient at least once a week for 26 weeks. No significant differences were found between the two groups in various measures of cardiac health.
The Monitoring and Actualization of Noetic Training (MANTRA) research project produced results after a pilot study and the complete study. The pilot project was cited widely because it had "encouraging" results, but these were not statistically valid because of the small number of participants.9 The ensuing RCT randomized 748 patients scheduled for cardiac catheterization.10 Patients first were assigned randomly to no prayer or to receive prayer from Christian, Jewish, Buddhist, and Unity Church groups. Then, all participants were randomized to receive either no additional complementary therapy or a combination of music, relaxed breathing, guided imagery, and Healing Touch. No statistically significant differences were found between the four groups for the primary outcomes measured.
The largest RCT of prayer to date was led by Herbert Benson and was published in 2006.11 In the Study of the Therapeutic Effects of Intercessory Prayer (STEP), 1,802 cardiac bypass patients were assigned to one of three groups. One was a control group and two groups received intercessory prayer from various Christian denominations. The two groups receiving prayer differed as one group knew they were being prayed for while the other group did not know whether they were receiving prayer or not. These groups were included to examine the role of suggestion. The primary outcome was the occurrence of complications after coronary artery bypass, which was not influenced by prayer. However, those who knew they were being prayed for had a higher complication rate than those who did not know the group to which they had been assigned (P = 0.025).
Problematic studies
Scientifically studying prayer has been controversial in itself, but a couple of studies have been particularly problematic. In 1998, a study with 40 AIDS patients randomly assigned them to either a control group or to receive psychic, shamanistic, Jewish, Christian, and Buddhist prayer.12 Of the 11 outcomes measured, those prayed for did significantly better in 6. However, after one of the researchers died, an investigative reporter discovered that the researchers had changed their protocol during the study and run different series of calculations that had not been planned originally.13 The data also were examined after blinding had been broken, but none of this was discussed in the original publication of the study results.
The controlled study of prayer with the most clearly beneficial results involved patients using in vitro fertilization.14 Those being prayed for had double the pregnancy rate of the control group (P = 0.001). However, one of the authors since has withdrawn his name from the publication.15 The author who organized the study, Daniel Wirth, has been jailed for fraud unrelated to this project, but this has cast a shadow of doubt over all his research.16 His supervisor and former colleagues have appealed publicly to him to clarify which of his publications are authentic.17 Two of the other small prayer studies were conducted by Wirth, who has not responded publicly to date.
Conclusion
Many of the early prayer studies were poorly designed and had few subjects. Most of the psychological studies were similarly small and had inconsistent results. The larger cardiac studies discussed here exemplify the current difficulty in reaching scientific conclusions about prayer studies. Individual outcomes sometimes show significant improvements in the prayer group, but for the most part the overall differences are not significant. The problematic studies add another level of concern to some of this research. Perhaps because this research raises questions about the relationship between religion and science, it may remain challenging.
Prayer studies can leave people with difficult or disturbing questions about whether science has proven or disproven the power of prayer. The inconsistency in these results shows that prayer studies have not provided a clear answer. However, some conclusions can be reached. If prayer involved an impersonal energy or subtle human energy, better research would be expected to reveal more consistent results. The results do not support this view of prayer. If, on the other hand, prayer involves a personal God who chooses how to answer, controlled studies will never be conclusive.2 Randomized, double-blind studies can control for the placebo effect, but not for divine choice. Within this view of prayer, inconsistent results are what would be expected.
Prayer will remain based on people's beliefs and not clinical evidence. Decisions about whether or not to pray always will remain in the area of personal faith and not scientific evidence. Scientific inquiry can shed light on many health questions, including some related to prayer. Studies can fruitfully investigate the experiences of those who pray and whether they report better outcomes than those who do not. But in many prayer studies, attempts to avoid religious issues have led to compromises that distort either the science or the religion. The cardiac studies emphasized scientific rigor, but failed to recognize the impossibility of controlling divine forces. The Mozambican study remained faithful to the religious practice, but compromised on scientific rigor.1 Science has its limits, and studying prayer as a controlled intervention exceeds one of them.
References
1. Brown CG, et al. Study of the therapeutic effects of proximal intercessory prayer (STEPP) on auditory and visual impairments in rural Mozambique. South Med J 2010;103:864-869.
2. O'Mathùna DP, Larimore W. Alternative Medicine: The Christian Handbook. Updated and expanded edition. Grand Rapids, MI: Zondervan; 2007.
3. Tyndall J. The Prayer-Gauge Debate. Boston: Congregational Publishing Society; 1876. Available at: www.archive.org/details/prayergaugedeba00meangoog. Accessed October 3, 2010.
4. Byrd RC. Positive therapeutic effects of intercessory prayer in a coronary care unit population. Southern Med J 1988;81:826-829.
5. Tindle HA, et al. Trends in use of complementary and alternative medicine by US adults: 1997-2002. Altern Therap Health Med 2005;11:42-49.
6. Lewis PJ. A review of prayer within the role of the holistic nurse. J Holistic Nurs 1996;14:308-315.
7. Harris WS, et al. A randomized, controlled trial of the effects of remote, intercessory prayer on outcomes in patients admitted to the coronary care unit. Arch Intern Med 1999;159:2273-2278.
8. Aviles JM, et al. Intercessory prayer and cardiovascular disease progression in a coronary care unit population: A randomized controlled trial. Mayo Clin Proc 2001;76:1192-1198.
9. Krucoff MW, et al. Integrative noetic therapies as adjuncts to percutaneous intervention during unstable coronary syndromes: Monitoring and Actualization of Noetic Training (MANTRA) feasibility pilot. Am Heart J 2001;142:760-769.
10. Krucoff MW, et al. Music, imagery, touch, and prayer as adjuncts to interventional cardiac care: The Monitoring and Actualisation of Noetic Trainings (MANTRA) II randomised study. Lancet 2005;366:211-217.
11. Benson H, et al. Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer. Am Heart J 2006;151:934-942.
12. Sicher F, et al. A randomized double-blind study of the effect of distant healing in a population with advanced AIDS: Report of a small scale study. Western J Med 1998;169:356-363.
13. Bronson P. A prayer before dying. Wired 2002:10. Available at: www.wired.com/wired/archive/10.12/prayer_pr.html. Accessed October 3, 2010.
14. Cha KY, Wirth DP, Lobo RA: Does prayer influence the success of in vitro fertilization-embryo transfer: Report of a masked, randomized trial. J Reprod Med 2001;46:781-787.
15. Jørgensen KJ, Hróbjartsson A, Gøtzsche PC. Divine intervention? A Cochrane review on intercessory prayer gone beyond science and reason. J Neg Results BioMed 2009;8:7.
16. Flamm BL. A timeline of fraud: Two decades of deception. Sci Rev Altern Med 2005;9:16-28.
17. Solfvin J, Leskowitz E, Benor DJ. Questions concerning the work of Daniel P. Wirth. J Altern Complement Med 2005;11:949-950.
In september 2010, the most recent study of intercessory prayer was published in the Southern Medical Journal. The researchers suggested that the key to prayer's effectiveness was proximity between the person praying and the one prayed for.Subscribe Now for Access
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