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Prayer under a microscope

THE BALTIMORE SUN

The names of the sick arrived at the Towson monastery by e-mail. Later in the day, gathering for Vespers, Sister Patricia Scanlan and the other Carmelite nuns would solemnly recite each new name aloud, beseeching God to restore these strangers to health.

Each day, millions of religious faithful around the globe make holy appeals like these in behalf of sick friends, relatives and even those unknown to them. Most take it on faith that their prayers make a difference. But now a handful of researchers are wondering: Do prayers from afar really have the power to heal?

To find out, scientists at some of the country's leading universities and hospitals are enlisting the help of religious groups to pray for people with AIDS, brain tumors and other illnesses. The Carmelites were among two dozen religious groups recruited by Duke University researchers studying the effect of distant prayer on heart disease.

Not surprisingly, the research has been highly controversial.

Although a handful of trials over the past two decades have hinted that distant prayer has a measurable effect on health, critics have dismissed these studies as deeply flawed and their results as little more than statistical sleight of hand. In some cases, suspicions have swirled that results might have been manipulated.

Studies of prayer have also irritated some theologians, who question whether it's appropriate - or medically useful - to put God under the microscope.

"Let's say that we show it has no effect - are we now going to tell people to stop praying?" asks Jeffrey Bishop, a physician, Episcopal priest and co-author of a critique of prayer studies in the Dec. 18 issue of the British medical journal BMJ. "If we show that prayer works, are we going to start writing prescriptions for prayer?"

Experts say the Duke University study, published this month in The Lancet, is the most rigorous clinical test of distant prayer to date. But it's not likely to settle the debate.

The study found that the prayers of the Carmelites and other religious groups had no statistically significant effect on more than 700 people preparing to undergo risky heart procedures. But scientific proponents of prayer research argue that it's too early to draw firm conclusions.

"At this point, I don't think there's enough data to conclude anything," says Marilyn Schlitz, a researcher at the California Pacific Medical Center in San Francisco who is conducting a federally funded study of distant prayer on wound healing. "We're still right at the very beginning stages of this type of research."

Tying God to science

The first scientist to put prayer to the test was Sir Francis Galton, a Victorian polymath and cousin of Charles Darwin who was best known as the father of eugenics and fingerprint identification. In 1872, Galton reasoned that because millions of Britons prayed each day for the health of the country's monarch, royalty would live longer than ordinary citizens.

But when Galton consulted the relevant statistical tables, he discovered to his surprise that the ruling class, on average, lived the shortest lives, dying earlier, on the whole, than doctors, lawyers and members of the army and navy.

For a century afterward, prayer remained largely untouched by science. Then, in 1988, cardiologist Randolph Byrd reported a prayer study of 393 heart patients at San Francisco General Medical Center. Published in the peer-reviewed Southern Medical Journal, it showed that patients prayed for by born-again Christians required less breathing assistance and fewer antibiotics and other drugs than patients who received no supplementary prayer.

The study generated considerable news media attention and piqued the interest of other scientists, despite criticism that it was poorly designed.

A few years later, Elizabeth Targ of the California Pacific Medical Center reported that the distant prayers of faith healers had had a positive health effect on a small group of AIDS patients.

In 1999, William Harris of St. Luke's Hospital in Kansas City, Mo., reported that coronary care patients who were prayed for by Christian groups fared better than patients with no assigned prayers.

Published in the Archives of Internal Medicine, the St. Luke's study tracked 990 heart patients and 35 measures of their health, including length of hospital stay, the drugs they required and the number of deaths reported.

Neither patients nor the study's organizers knew who was receiving prayers, which were offered on a patient's behalf each day for four weeks.

Research quandaries

But even proponents of prayer research concede that evaluating something so ineffable is fraught with challenge. And studies over the years have struggled to reconcile the notion of prayer with the gold standard in clinical research: the "double-blind, placebo-controlled" trial.

In this type of study, patients are randomly assigned to receive either an experimental treatment or a dummy therapy, known as a placebo. To prevent unintended bias, neither experimenters nor volunteers are supposed to know who receives which treatment until the study is complete.

But in a prayer study, how do you define a dose? Unlike a cancer drug, "you can't just draw up 400 cc's of prayer," says Bishop.

It's also impossible, some scientists argue, to create a valid control group for comparison, because it would be unethical to ask a sick volunteer - or his family - to stop praying in his behalf during the study.

If volunteers in the control group were to secretly pray for themselves, would that skew the results? And how should experimenters account for all the generalized prayers for the sick that millions around the world offer every day?

"All of this is something to look into further," contends Mitchell Krucoff, a Duke University cardiologist and prayer researcher who led the new Lancet study. "We do not have a prayer-proof room."

Study suspicion

Past prayer studies, meanwhile, have been criticized for sloppy design and for including so many variables that researchers start to see patterns where there are none.

"They measure one variable after another until they find something then they say, 'Ah-ha!" says Richard Sloan, a professor of behavioral medicine at Columbia University.

In a few cases, researchers conducting distant prayer studies have come under suspicion of intentionally manipulating their results.

In 2002, Wired magazine disclosed that Targ and her colleagues relied on questionable techniques to evaluate data from their early AIDS study, possibly skewing the results.

Due in part to her findings, Targ won government grants for two more studies on distant prayer - one for a follow-up investigation of prayer and AIDS, the other for glioblastoma, a rare brain tumor.

California Pacific Medical Center conducted an internal investigation that ultimately cleared Targ, who, in an unusual coincidence, died that same year of the same rare brain cancer she had been studying. One of Targ's colleagues is completing the two trials she began.

Last year, the results of a high-profile study on prayer and fertility were also called into question.

In 2001, Kwang Cha, then a visiting researcher at Columbia University, reported that women who were prayed for by others became pregnant twice as often as women who didn't have intercessors praying in their behalf.

The research, which appeared in The Journal of Reproductive Medicine, soon became known as the "Miracle Study." But critics now argue that the only miraculous thing about the research is that it was published at all.

Early last year, one of its co-authors, Daniel Wirth, was convicted of an unrelated fraud charge. Then, in December, Columbia announced that the study's senior author, Rogerio Lobo, was withdrawing his name from the report.

While the study's results have never officially been declared suspect, some scientists say that the circumstances are suspicious.

"The study was absurd, flawed, possibly fraudulent, and claimed to document mysterious supernatural and/or paranormal events," Bruce Flamm, an obstetrician at the University of California, Irvine, wrote in the March issue of Skeptical Inquirer magazine.

Despite the critics, some scientists argue that prayer remains a valid subject of study, if only because it's so widely practiced. A Harvard Medical School survey published last year, for example, found that one-third of U.S. adults pray as a complement to conventional medical care.

"For thousands of years, when someone gets sick, people say, 'Let's say a prayer,'" says Rabbi Jeffrey Orkin, director of pastoral care at the Levindale Hebrew Geriatric Center and Hospital in Baltimore. "The more research out there, the better."

Unpublished report

Some scientists are wondering whether an as-yet unpublished study led by Harvard Medical School cardiologist Herbert Benson will help clear up lingering scientific questions about distant prayer.

The trial, known as STEP, involved 1,802 people at six U.S. hospitals who were preparing to undergo coronary artery bypass surgery, making it the largest study of distant prayer to date.

But nearly five years after researchers stopped collecting patient data, the study has yet to appear in print. Jeffrey Dusek, a scientist involved with the study, says he and his co-authors would not discuss the research until it was published, which he says could happen next year.

He would say only that the paper is "at a journal" and under evaluation. Alluding to the problems that have beset previous studies, Dusek adds, "We want to be as clean as a hound's tooth."

But other scientists are suspicious. "If they had something, we'd know about it by now," says Columbia's Sloan, a frequent critic of distant prayer research. Even officials at the John Templeton Foundation in Philadelphia, which spent $2.2 million to finance the study, are anxious for results.

"It has the appearance of being scandalous that it's taken so long to publish," says Charles Harper, a senior vice president at the foundation. The foundation itself, he says, sent the researchers a letter last year complaining of the delay.

For some in the religious community, the outcome of the study won't matter. Sister Patricia of the Carmelite Monastery on Dulaney Valley Road, who served as the liaison with Duke University researchers, is one of them.

"Our society likes proof for things. But people who think they've been healed through [distant] prayer, they don't need a study to tell them that. To people of faith, it's a fact," she says.

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