Praying for Science

Can prayer help the ill?

Invoking God’s good will to help the sick has been a mainstay of Christianity for 2000 years. God’s role as physician-in-the-sky is manifest at Lourdes, Fatima, and countless other sites that attract hordes seeking supernatural help for natural afflictions. But with the increasing scientific basis of medicine God’s role has diminished to a fall back position — the plan B god.

Our question, can prayer help the ill?, lies at the intersection of science and religion, of the ancient and the modern. At first sight, it appears to be scientific since it is testable and therefore falsifiable. But I will argue that things are not so simple. Furthermore, the theology is even more suspect than the science. It turns out it is not easy living at an intersection.

The earliest attempt to answer the question was made by Sir Francis Galton in 1872. Galton, a cousin of Darwin, was a Victorian gentleman with an epic range of interests and talent. One of a small cadre of polymaths that Europe and America seemed to throw up at will in the 19th century, Galton had a hand in founding or expanding psychology, geography, meteorology, genetics, statistics, forensics, and anthropology. Fascinated with his cousin’s work on evolution, Galton threw himself into studies of human nature, and introduced the use of statistics and surveys in his research. Twin studies were first used by Galton in his research on inheritance, as were the phrases, regression to the mean and nature versus nurture. Galton also coined the word eugenics and was an early proponent of the idea of improving the lot of mankind through careful breeding. Of course the idea and the field fell out of favor after it was appropriated by the Nazi intelligencia. These days the Galton Chair of Eugenics at University College London is called the Galton Chair of Genetics.

Galton’s idea to test the efficacy of prayer was simple: royalty in the UK are regularly prayed for since they head the Anglican Church. He therefore undertook to compare the average lifetime of members of the royal family to other persons of wealth. His results were published in the Fortnightly Review as Statistical Enquiries into the Efficacy of Prayer.

Galton prepared a table of average lifespans based on data he collected himself which showed no evidence for royal longevity, and hence, no evidence for the efficacy of prayer in promoting good health: “The sovereigns are literally the shortest lived of all who have the advantage of affluence. The prayer has therefore no efficacy, unless the very questionable hypothesis be raised, that the conditions of royal life may naturally be yet more fatal, and that their influence is partly, though incompletely, neutralised by the effects of public prayers.”

Although not definitive, one might think that Galton’s study would have dampened any enthusiasm for further scientific tests. But it is estimated that five million dollars is spent annually on the subject, that about 1/2 of American medical schools offer courses on spirituality and health, and that about 1000 articles are published per year on the subject.

Let’s take a look.

Religious Factors and Hippocampal Atrophy in Late Life

Dr Amy Owens of Duke University and colleagues decided to use MRI scans to check the correlation of brain structure with religiosity. Surprisingly they found one!: “Significantly greater hippocampal atrophy was observed from baseline to final assessment among born-again Protestants, Catholics, and those with no religious affiliation, compared with Protestants not identifying as born-again.” Of course the correlation was immediately turned into causation by the media: “New research finds membership in a minority religion seems to hasten a loss of volume of the hippocampal region of the brain.”

I am not sure that this bizarre result deserves any more thought, other than to remind ourselves just how flakey MRI research can be (dead salmon knows!).

A Randomized, Controlled Trial of the Effects of Remote, Intercessory Prayer on Outcomes in Patients Admitted to the Coronary Care Unit

Even though the paper starts with the line

From time immemorial, prayer for the sick has been a common response to the illness of a loved one,

this is a more serious effort, published in JAMA’s Archives of Internal Medicine. Dr W.S. Harris and pals examined 990 patients who had been admitted to the Coronary Care Unit at the Mid America Heart Institute in Kansas City. The study was double blind and has a decent sample size (good!) and did indeed find a significant difference (p=0.04) between outcomes of the group being prayed for over the control group.

Remote, intercessory prayer was associated with lower CCU course scores. This result suggests that prayer may be an effective adjunct to standard medical care.

It’s looking good for prayer! But the authors note

There were no statistically significant differences between groups for any individual component of the MAHI-CCU score. Mean lengths of stay in the CCU and in the hospital (after initiation of prayer) were not different, and median hospital stay was 4.0 days for both groups. There was no significant difference between groups using Byrd’s hospital course score.

In other words, if you look at other ways to score the patients, no difference in outcomes is seen. This is, in fact, a serious issue in study design. The metric you use can swamp the observable. The same thing happens in particle physics, where scientists can choose to exclude parts of their data (called a cut) with a click of the mouse. The temptation to experiment with cuts is irresistible and inevitably leads to an anomaly. If you do something 100 times, on average you will find a one percent occurrence. To prove the point, a 2006 study with 1802 CCU patients at six hospitals found no effect.

Theology

I am no theologian, and I haven’t consulted any in writing this post, but there seems to be something seriously amiss on the religious side of this story. Surely it is sacrilegious presume that we can explore the mind of God like he is a weighted spring in a middle school science experiment. If prayer studies made sense one could determine which religion God prefers

or how much the piety of the prayer can influence God’s actions

or how receptive God is to prayer as a function of distance

Study of the therapeutic effects of proximal intercessory prayer (STEPP) on auditory and visual impairments in rural Mozambique

I had looked at these examples as amusing illustrations of the foolishness of prayer studies. But bless her heart, along comes Dr Candy Brown of Indiana University who blithely jumps right in. Yes indeed, Dr Brown and colleagues have found that proximity of intercessor and patient is correlated with health outcomes!

This wretched research came with a commentary in the Southern Medical Journal written by Dr. John Peteet of Harvard. Dr Peteet was open-minded, writing

But the conviction that we live in a closed system governed only by naturalistic processes is an expression of faith in a world view rather than a conclusion logically demanded by the scientific method.

I have difficulty parsing this thought. Is he saying that prayer lies outside of “naturalistic processes”? If so, then how can its efficacy be tested in experiments? What does he mean by a “closed system”? I suppose he is thinking of some sort of spiritual metauniverse with ‘natural’ and ‘supernatural’ portions. Can one then call the union of the two closed? And is he trying to say that science is not a logical demand of science? I suppose that this is a true, but utterly useless, statement about metalogic. Frankly, I am not remotely surprised that this level of muddleheadedness is associated with prayer studies.

In the end, prayer studies are not scientific either. Omniscient and omnipresent deities need not respond in predictable ways to intercessory invocations. I am sure that the religious would say “God does not choose to reveal himself” to any outcome whatsoever from a prayer study. So what is really being studied? It certainly isn’t science and it certainly isn’t religion.