When Prayers Attack

Well, it's official. If you're scheduled for a coronary bypass, and the local Ned Flanders is busy organizing the congregation to pray for you, order the bastard to cease and desist immediately. Science has determined that intercessory prayer may significantly increase the risk of post-surgery complications for you.

This month's issue of the American Heart Journal has a paper by Benson et. al. on the effectiveness of intercessory prayer. They begin the paper by saying:

Intercessory prayer is widely believed to influence recovery from illness, but claims of benefits are not supported by well-controlled clinical trials. Prior studies have not addressed whether prayer itself or knowledge/certainty that prayer is being provided may influence outcome. We evaluated whether (1) receiving intercessory prayer or (2) being certain of receiving intercessory prayer was associated with uncomplicated recovery after coronary artery bypass graft (CABG) surgery.

And their conclusion?

Intercessory prayer itself had no effect on complication-free recovery from CABG, but certainty of receiving intercessory prayer was associated with a higher incidence of complications.

In English: Prayer is ineffective at best, and knowing that you're being prayed for can be a risk factor as well.

The doctors are to be commended for three things: (1) for having the cojones to study the supernatural; (2) for giving "intercessory" a slightly sinister connotation; and (3) for making the Universe a slightly funnier place.

The basic idea of the study is quite simple. There are two control variables: prayer and awareness. Either a patient may or may not be prayed for and the patient may or may not be told this fact. That gives four groups of patients, and the figure shows the number of patients assigned to the various groups in the study. Note that a patient was never told that he is not being prayed for; that of course would be unethical.

What the doctors measured were the number of complications post-surgery (the Society of Thoracic Surgeons has defined these complications in a reasonably precise way). It is here that the study becomes interesting. What the Benson team found was that the least number of complications occurred in the group of patients who were not prayed for and were ignorant of that fact (Group 2). The largest number of complications occurred in the group of patients who were prayed for and were aware of that fact (Group 3). In the figure, the red arrows show the direction of increasing risk.

The results are statistically significant; that is, it is unlikely that these numbers could've obtained by pure chance. Benson et. al. are strangely reluctant to make this conclusion. In their words:

We have no clear explanation for the observed excess of complications in patients who were certain that intercessors would pray for them (group 3)... the excess may be a chance finding.

But, in an otherwise laudatory review, the lead editorial in the same issue of the American Heart Journal heaped scorn on this pusillanimity:

While presenting these results clearly and noting them in discussion, the investigators take an almost casual approach towards any explanation, stating only that it "may have been a chance finding." It is rather unusual to attribute a statistically significant result in the primary end point of a prospective, multicenter randomized trial to "chance." .... If the results had shown benefit rather than harm, would we have read the investigators' conclusion that this effect "may have been a chance finding" with absolutely no other comments, insight or even speculation. [Amer. Heart J. 151(4).  pp. 762-764].

They go on to argue that cultural biases should not stand in the way of studying religious phenomenon. They're absolutely right. Religion is not within the purview of science. But religious claims are. It's an idea that has been gaining steam in recent years. Generally, scientists have held back, been apologetic for negative results and avoided confrontation. It'd be interesting to see if Medicine becomes the new villain in the minds of the faithful; Evolution now bears the brunt of the animus. 

Medicine has always been the cradle of scientific thinking. It is inherently democratic (the physician touches all), inherently rooted in natural explanations and inherently self-correcting in that an idea that cures usually survives over one that doesn't. These features make medicine a radical science.

Ancient Indian medicine offers one of the best examples of what happens when the theocracy understands this fact. Ayurveda, which started out as a materialistic, experimental study of diseases, dengenerated into a logical but irrational system of superstitions. Not many people are aware that both medicine and physicians are heartily condemned in most of the sacred Indian texts; text after text lumps physicians with thieves, fowlers, washermen, cobblers, harlots and eunuchs. This was a historical shift. In the Rg-Ved, the Asvini brothers, twin physicians to all the other Gods, hold a high and honored place. But by the time the Yajurveda was composed, things had taken a drastically different turn. Brahmins are strongly prohibited from practicing medicine. Physicians are listed amongst the unclean. In the Taittiriya-samhita, one of the rescencions of the Black Yajurveda, there's a part where Ashvini twins are denied their share of their sacrificial offering. They are made to barter their services for a share and to undergo a purification ceremony (specifically, Bahispavamana); both would've been unthinkable in the Rg-Ved. Clearly, medicine had been put in its place.

The results of the Benson study are not as significant as the fact that it was undertaken in the first place. Medical, pharmacological and neurophysiological experiments may finally help Religious Studies achieve what William James so boldy hoped almost a century ago: a genuinely scientific examination of religious phenomenon.