If the practical content of and petitions in the prayer are important, how does God make decisions about what is and what is not a reasonable request? If the faith or conviction of the persons who pray is important, does God value the beliefs of the petitioners more than the merits of the petitions?
If the personal characteristics and qualities of the persons who pray or the persons who are being prayed for are important, are some people more equal before God than other people? Religions portray God as being compassionate; what sort of compassion is displayed by the selective favoring of an experimental over a control group?
If the entity to which the prayer is directed is important, do different Gods have different portfolios? Are some Gods more approachable? Do some Gods ignore some prayers? If the religious affiliation of the person who prays is important, what becomes of the other religions of the world and those who follow such religions; will their prayers remain unanswered?
If the magnitude of response to the petitions is total, then all prayers should result in miraculous or near-miraculous benefits. This, clearly, almost never happens. Thus, does God work on percentages; that is, if the petition is for an elephant, does he sanction a mouse? Or, are his responses only subtle ones? If so, how does he choose on the outcome measure to improve?
These questions are unsettling to those who pray because of their theological implications, but they are also unsettling to scientists because they challenge the design, analysis and interpretation of randomized controlled trials of the efficacy of intercessory prayer. Consider the following:. It could be difficult, if not impossible, to measure all the independent and confounding variables that are important in such research. For example, how might one measure faith, fervency, reasonableness, worthiness, religiosity, morality and other abstract constructs?
How might one define what is an acceptable response to prayer? Healing can be partial or complete. It can be psychological or physical. It can be abstract or concrete. Confounding the picture, statistically significant improvement can be identified only if the same outcome measure is improved in a sufficiently large number of experimental relative to control patients, but why should God decide to select any one outcome measure over the rest? And if different outcome measures improve in different experimental patients in response to prayer, there is no way in which the improvement can be statistically detected.
As atheists, in general, form a minority in most populations, in any randomized controlled trial of intercessory prayer, there is likely to be a number of persons friends, relatives and the patients themselves praying for members of both experimental and control groups, unknown to the researchers. If prayer works, this unmeasured source of healing could diminish intergroup differences in outcomes. As inferential statistical tests will be applied to the data generated by randomized controlled trials of intercessory prayer, is it valid to assume that acts of God conform to normal, t or other statistical distributions?
Or that God responds mechanistically to prayer, in a manner that follows laws of probability? In this context, miraculous healings are considered to be outside the provisions of nature, and so divine intervention could actually be expected to violate probability. Alternately, if prayer is a nonlinear variable, the merits and demerits of which are decided upon by God, then one prayer made by a control patient or relative can statistically offset a multitude of intercessory prayers offered on behalf of the experimental patients.
In fact, if divine intervention is selective or arbitrary in response to petitions, the entire basis of randomized controlled design and inferential statistical analysis becomes invalid. From a scientific perspective, if prayer is indeed considered to work, thought should also be given to the possibility that it may not require a deity.
It may, instead, invoke some hitherto unidentified mental energy that has healing power. If so, might prayer be more effective if those who pray are in closer proximity to those who are being prayed for?
Might the direction in which persons face while praying matter? Might the assistance of the physical sciences be required to identify the nature of the biological energies at work? It should be noted that the distant healing, intercessory prayer studies specifically test the intervention of a divine entity.
This is because the intercessors are usually blind to the identities of the patients for whom they pray, or at least because the intercessors do not have any contact with these patients. Therefore, it is left to a sentient being to miraculously divine the intent of the prayers and apply the intercession to the correct target. Of note, distant healing, intercessory prayer studies address soft diagnoses with soft outcomes.
No study, for example, has examined whether prayer can result in the disappearance of medically proven tumors and metastases, reversal of traumatic paraplegia or revival from a state of brain death. It would seem that the results of such studies could be more convincing than the results of studies on wound healing or successful pregnancy. Could it be that those who pray believe that God has or sets limitations? If research on intercessory prayer is positive, does it suggest to us ways and means by which we can manipulate God or make his behavior statistically predictable?
Why would any divine entity be willing to submit to experiments that attempt to validate his existence and constrain his responses? In this context, we must keep in mind that religion is based on faith and not on proof. This implies that, if God exists, he is indifferent to humanity or has chosen to obscure his presence. Either way, he would be unlikely to cooperate in scientific studies that seek to test his existence.
Where does this leave us? God may indeed exist and prayer may indeed heal; however, it appears that, for important theological and scientific reasons, randomized controlled studies cannot be applied to the study of the efficacy of prayer in healing. In fact, no form of scientific enquiry presently available can suitably address the subject. Therefore, the continuance of such research may result in the conducted studies finding place among other seemingly impeccable studies with seemingly absurd claims Renckens et al.
Whereas we have attempted to be scientifically and politically correct in our critique, other authors, such as Dawkins,[ 43 ] have been humorous, nay even scathing, in their criticism.
The aim of science is not to open a door to infinite wisdom but to set a limit to infinite error attr. Dusek et al. A Bayesian approach to the analysis of research of this nature may carry advantages over the conventional approaches. Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology Information , U. Journal List Indian J Psychiatry v. Indian J Psychiatry. Author information Copyright and License information Disclaimer. Address for correspondence: Dr.
E-mail: moc. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC. Abstract Religious traditions across the world display beliefs in healing through prayer. Keywords: Healing, miracles, prayer, randomized controlled trials, research design. Prayer may be supported by varying degrees of faith and may therefore be associated with all the benefits that have been associated with the placebo response Clinically significant treatment gains have been observed with placebo in numerous disorders, including anxiety, depression, schizophrenia, obsessive-compulsive disorder, tardive dyskinesia, ischemic heart disease, cardiac failure, Parkinson's disease and even cancer, among a host of other conditions.
Prayer may be associated with improvements that result from spontaneous remission, regression to the mean, nonspecific psychosocial support, the Hawthorne effect and the Rosenthal effect Spontaneous remission is well known to occur in conditions that range from medical disorders e. Prayer may result in benefits that are due to divine intervention Although the very consideration of such a possibility may appear scientifically bizarre, it cannot be denied that, across the planet, people pray for health and for relief of symptoms in times of sickness.
Absence of benefits with prayer Aviles et al. Worse outcomes associated with prayer Benson et al. Retrospective benefits with prayer Leibovici[ 39 ] reported the results of an unusual study that was conducted in Israel. By invoking prayer, researchers invite troublesome questions about the importance of several theosophical matters: Do the quantitative aspects of prayer influence outcomes? Would the outcomes depend on the entity at whom the prayers are directed?
Consider the following: It could be difficult, if not impossible, to measure all the independent and confounding variables that are important in such research. We close our critique with two final questions: If research on intercessory prayer is positive, does it suggest to us ways and means by which we can manipulate God or make his behavior statistically predictable?
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