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Faith Healing by Prayer:
Review of a Questionable Study
Bruce L. Flamm, MD,
Can prayer influence the success of in
vitro fertilization (IVF) embryo transfer? The lead article in
the September 2001 issue of the Journal of Reproductive Medicine
claimed to have demonstrated that it can . The report's
authors, two of whom were faculty members at Columbia University's
College of Physicians and Surgeons, claimed to have demonstrated
that distant intercessory prayer can double the success rate.
In this study, 219 infertility patients in Seoul, South Korea,
apparently required and underwent in vitro fertilization (IVF).
Twenty patients were excluded prior to randomization due to incomplete
data, leaving 199 study subjects. After randomization, 100 patients
received prayer and 99 did not. Thirty additional patients were
subsequently eliminated from the study due to failure of embryo
transfer, leaving 88 patients who had prayer and 81 who did not.
In vitro fertilization was performed in the usual fashion in both
groups. The patients in the prayed-for group were not informed
that Christian groups in the United States, Canada, and Australia
were praying for them. The pregnancy rate in the prayed-for group
(50%) was essentially twice as high as the pregnancy rate in the
non-prayed-for group (26%). At first glance, this success rate
may seem remarkable. But a close look suggests otherwise.
Any claim of successful treatment, including
faith healing, must meet certain criteria. First, it must be established
that some type of illness or medical condition actually existed.
On any Sunday, revival-tent faith healers and televangelists claim
to restore vision to the blind and limb function to the lame.
To many people, the sight of wheelchair-bound invalids standing
up and walking (or even running) away from their wheelchairs is
convincing evidence. But no such miracle healing has been scientifically
authenticated. When these cases are investigated, it is often
found that the infirmity did not exist or was psychosomatic .
Furthermore, the human body has intrinsic healing mechanisms and
will frequently recover from illness or injury even when no treatment
is rendered. Any claim of successful treatment, medical or otherwise,
must therefore account for these factors.
The study's authors -- Kwang Cha, M.D., Rogerio Lobo, M.D.,
and Daniel Wirth -- stated that their results
were preliminary, but that their rigorous study design and careful
methodology made them valid. Nevertheless, several questions arise
about the study design.
- Twenty of the initial 219 patients
had to be eliminated from consideration due to "fragmentary
e-mail transmission." The nature of the data transmission
problem is not explained. One wonders if other data transmission
problems of a lesser degree might cast doubt on the remaining
data. Were all problems with e-mail transmission of any degree
limited to these 20 patients?
- The authors claim that "we set
out with the expectation that we would show no benefit of intercessory
prayer." This is a questionable claim for at least 2 reasons.
First, many studies have failed to demonstrate any medical benefit
of intercessory prayer. It would seem doubtful that anyone would
embark upon an international study of this magnitude to simply
add another negative study [3,4]. Second, 1 of the study's 3
authors has a long history of publications that appear to sup-port
spiritual and prayer-based faith healing [5-11]. Several of these
studies originated from an entity called Healing Sciences Research
International located in Orinda, California.
- In an apparent effort to demonstrate
a lack of bias, the authors point out that, "none of the
authors are [sic] employed by religious organizations, and we
were not asked by any religious groups to conduct this trial,
nor did we seek religious advice at any time." However,
the authors did not disclose any other religious affiliations
that could introduce bias. Most people engage in religious organizations
as volunteers, not as paid employees. A later comment stated
that, "most intercessors were known to one author."
The reader may wonder if any other authors actually had strong
religious convictions and/or affiliations. The reader can surmise
that at least one of the researchers had attachments to some
of the participants, since most of these extremely religious
people were "known to one author."
- The study protocol seems unnecessarily
convoluted and there is no explanation given for the bewildering
study design. A straightforward test to evaluate if prayer is
efficacious in increasing the success rate of IVF would be to
simply have 1 or 2 people secretly pray for success in randomly
selected study patients. Patients would consent to the study
but would not be told if they were being prayed for. In contrast
to this straightforward approach, the study involved at least
3 different levels of variously overlapping and intertwining
prayer groups praying for entire groups of patients. Tiers 1
and 2 each consisted of 4 blocks of prayer participants. Prayer
participants in tier 1, block A, received a single sheet of paper
with 5 IVF patients' pictures, called a "treatment unit."
The 5-patient "unit" was apparently chosen because
5 photos fit conveniently on a single page. Prayer participants
in tier 1, block A, prayed in a directed manner with a specific
intent to "increase the pregnancy rate" for patients
in the assigned unit. Prayer participants had no information
about the patients they were praying for except for a photograph
(no name, no age, etc.) on a page with 4 other photographs. Prayer
participants in tier 2, block A, were asked to perform 2 different
types of prayer. First, they prayed for the prayer participants
in tier 1, block A, with the intent to "increase the efficacy
of prayer intervention." In other words, they were apparently
praying to increase the effectiveness of their colleagues' prayers,
whatever those prayers might be. The study design is no longer
testing whether prayer works but rather testing whether prayer,
when reinforced by overlapping layers of prayer participants
praying for each other, works. Next, prayer participants in tier
2, block A, also prayed in a nondirected manner for the study
patients with the "intent that God's will or desire be fulfilled
in the life of the patient." Similar nondirected prayers
apparently took place in all of the other prayer blocks. Finally,
in addition to all of the above groups, tiers, blocks, and units,
a separate group of 3 individuals prayed in a general, nonspecific
manner with the intent that "God's will or desire be fulfilled
for the prayer participants in tiers 1 and 2." In other
words, these final 3 prayer participants were apparently praying
to increase the efficacy of the second tier of prayer participants,
who were in turn praying to increase the efficacy of the first
tier of prayer participants, who were in turn praying for increased
pregnancy rates in the study patients. The authors offer no explanation
for this confusing study design.
- Including prayers asking that "God's
will or desire be fulfilled" introduced a vague and obfuscating
concept that cannot be measured as an endpoint. This maneuver
offers additional chances for successful outcome. In other words,
if a given patient failed to get pregnant in spite of intercessory
prayers, one might still conclude that the prayers were successful,
since one could argue that the will of God was fulfilled and
his will for that patient was for her to remain infertile.
- The authors made no attempt to discover
how much prayer was being conducted, outside of the study protocol.
on behalf of the study patients. Patients in the study had suffered
from infertility for an average of 5 years. When infertility
patients finally undergo IVF, their last hope for pregnancy,
personal appeals to deities are not surprising. It is also extremely
likely that friends and family members were praying for many
of the study patients. The problem is that one has no way of
knowing who was prayed for by whom, and how this could have affected
the study results. Logistic regression was used to evaluate possible
confounding variables such as patient age and duration of infertility
but no attempt was made to determine if the study groups were
biased by Other sources of prayer, the very thing the study set
out to investigate. Koreans are approximately 1/3 Buddhist, 1/3
Christian, and 1/3 non-religious or of other religions .
Many or all of the patients in the group receiving Christian
prayer may have also been receiving Buddhist or Shamanist prayers.
Which prayers, if any, influenced the IVF success rates?
- The observed statistically significant
difference may be misleading. As with homeopathic and psychic
research, this kind of study is most likely a contest between
2 placebos. Depending on how many ways there are to win and how
many times the study is done, a statistically significant result
can be demonstrated. The chances of finding at least one "statistically
significant" (p = .05 or less) difference between approaches
100% as more and more endpoints are measured and as the calculations
are made in more imaginative ways. A humorous discussion of the
statistical limitations of the Cha et al. study can be found
in the Skeptic's Dictionary .
- Although it is distasteful to ponder
the possibility of intentional manipulation of study data, Occam's
razor (the principle that a simple explanation rather than a
convoluted one is more often correct) demands that this possibility
not be ignored when highly unlikely results are encountered.
Simply stated, is it more likely that data were compromised,
or that the study proved the existence a supernatural power and
may be one of the most important scientific publications in history?
From the onset of data collection to the final data analysis,
everyone with access to study data could have been aware of the
study's importance. Although the authors explain that they used
careful masking techniques to avoid this type of problem, it
is always possible that, unknown to the authors, the data were
Recent developments have raised questions about the study's
raw data. Dr. Lobo, identified by the New York Times and ABC News
as the report's lead author, now claims to have not been involved
with the study until after its completion and to have provided
only "editorial assistance." Both he and Dr. Cha have
refused to respond to phone calls or letters about the study.
The remaining author, Daniel Wirth, has no medical degree but
has published many studies claiming to support the existence of
paranormal phenomena. Many of these studies originated from an
entity called, "Healing Sciences Research International,"
an organization that he supposedly headed. This entity's only
known address was apparently a Post Office box in Orinda California.
Wirth holds an MS degree is in the dubious field of "parapsychology"
and also has a law degree.
In April 2004, Wirth and an accomplice
(Joseph Horvath) pleaded guilty to conspiracy to commit mail and
bank fraud and agreed to forfeit assets of more than $1 million
acquired through their schemes. Documents in the case indicate
that the pair used assumed names, obtained bogus identifying documents,
and obtained employment with a large financial institution from
which Horvath improperly paid to Wirth for alleged services .
Wirth's long pattern of dishonest behavior raises the question
about whether the studies in which he was involved actually took
place and, if so, whether the results were reported honestly.
- Cha KY, Wirth DP, Lobo RA. Does
prayer influence the success of in vitro fertilization-embryo
transfer? Journal of Reproductive Medicine
- Randi J. The Faith Healers. Amherst,
NY: Prometheus Books, 1989.
- Glickman R, Gracely EJ. Therapeutic
touch: Investigation of a practitioner. Scientific Review of
Alternative Medicine 2(1):43-47, 1998.
- Sloan RP, Bagiella E, Powell T. Religion,
spirituality, and medicine. Lancet 353:664-667, 1999.
- Wirth DP, Cram JR. The
psychophysiology of nontraditional prayer.
International Journal of Psychosomatics 41:68-75, 1994.
- Wirth DP, Cram JR. Multisite
electromyographic analysis of non-contact therapeutic touch. International Journal of Psychosomatics 40:47-55,
- Wirth DP, Marrett MJ. Complementary
healing therapies. International Journal
of Psychosomatics. 41:61-67, 1994.
- Wirth DP. The
significance of belief and expectancy within the spiritual healing
encounter. Social Science & Medicine
- Wirth DP, Richardson IT, Eidelman WS.
healing and complementary therapies: A review.
Journal of Alternative and Complementary Medicine 2:493-502,
- Wirth DP, Cram JR, Chang RJ. Multisite
electromyographic analysis of therapeutic touch and qigong therapy. Journal of Alternative and Complementary Medicine
- Wirth DP, Cram JR. Multisite
surface electromyography and complementary healing intervention:
a comparative analysis. Journal of
Alternative and Complementary Medicine 3:355-364, 1997.
- Johnstone, P. Operation World: The
Day-By-Day Guide to Praying for the World. Grand Rapids, Mich:
Zondervan Publishing; 1993.
- Carroll B. Mass
media bunk. Skeptic's Dictionary Web site, accesses May 28,
- Fourth superseding indictment.
U.S.A. v. John Doe (FBI No. 034055NA9) and Joseph Wirth. U.S.
District Court for the Middle District of Pennsylvania. Filed
Feb 12, 2004.
Dr. Flamm is an obstetrician/gynecologist with Kaiser Permanente
Medical Group, Riverside, California and Clinical Professor of
Obstetrics and Gynecology, University of California, Irvine. Portions
of this article were originally published in The
Scientific Review of Alternative Medicine 6(1):47-51), 2001.
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