Inherent Dangers of Faith-Healing Studies
Author: Bruce L. Flamm, MD
Abstract:
It is often claimed that faith healing may not work but at least does no harm. However, as will be demonstrated in
this article, reliance on faith healing can indirectly cause serious harm and even death. Therefore, there is an inherent
danger in the publication of studies that advocate healing by faith. Nevertheless, dozens of studies claiming
to have confirmed some therapeutic value of distant prayer and other "distant healing" methods have recently appeared
in the medical literature. Although faith healing has been advocated by religious groups for millennia, the
issue here is the propriety of making supernatural claims in medical journals. It is one thing to tell an audience at
a religious revival that prayers yield miracle cures, but it is quite another thing to make the same such claims in a
scientific journal.
This article is the third in a series that use the Cha et al. faith-healing study [1] as a model to demonstrate the problems that arise when faith-based studies are published in medical journals. The first article investigated methodological flaws in faith-based studies while the second article focused on paradoxical questions that arise in such publications. [2,3] This third article will evaluate several of the dangers inherent in the Cha study and all similar publications.
1. Faith healing can cause patients to shun effective medical
care.
This is perhaps the greatest danger of any study that
touts the efficacy of faith healing. In the Cha study, prayer
appeared to double the in vitro fertilization (IVF) success
rate. Since any method that can increase the success rate
of IVF by even a few percent would be hailed as a major
achievement, these results were astounding. The news
media were quick to disseminate this seemingly favorable
information to the public. [4-6] The apparent effects of
prayer were so dramatic that it would not take a "leap of
faith" for infertile women to conclude that prayer is more
effective than medical intervention as a cure for infertility.
This conclusion could cause some women to forgo
medical care and thus miss out on the proven benefits of
modern infertility treatments. In other specialties the
consequences of avoiding medical care because of reliance
on religious rituals and faith healing have been
well documented. [7] A recent study identified 158 children
who died due to reliance on faith healing and religion-
motivated medical neglect. [8]
2. Doctors who accept faith-healing study results might diminish
their medical efforts.
Doctors as well as patients might change attitudes
and practices in response to faith-healing studies published
in medical journals. Why worry about proper clinical
techniques and strict laboratory protocols that could
at best potentially increase pregnancy success rates by a
few percentage points when prayer is easy and far more
efficacious? This may seem ridiculous, but if the Cha
study results are to be taken seriously, it is not illogical.
On the other hand, if the Cha study results are not to be
taken seriously, why were they published in a peerreviewed,
scientific medical journal?
3. Faith-healing studies could steer third-party payers toward
faith-based interventions.
In the United States each IVF treatment cycle costs
an average of $9,000, and several cycles are often required
to achieve a viable pregnancy. For patients who require
IVF, the cost of each live birth has been estimated
at over more than $50000. [9] Since IVF is costly for health
insurance companies, if the Cha study results were valid,
it would be logical for these organizations to advocate the
introduction of prayer into infertility programs. The
claimed doubling of IVF success rates could save insurance
companies an average of $25000 per patient. With
millions of dollars at stake and with these compelling
study results as evidence, insurance companies could insist
that prayer be tried first.
4. Faith-healing studies raise informed consent issues.
The Cha study was conducted without informed
consent. This is unethical, potentially dangerous, and
possibly illegal. Placebo effect could have been avoided by
first properly informing patients about the study and
then, with their permission, blinding them to which
group they were assigned. Lack of consent perhaps explains
why none of the prayer recipients was located in
the United States. Nevertheless, it is doubtful that the institutional
review board of any university in the United
States would waive the informed consent requirement
simply because the patients to be experimented upon
lived outside of the United States.
Using patients as research subjects without informed consent also violates both the Nuremberg Code and the Helsinki Declaration. Furthermore, it is not logical to claim that informed consent was unnecessary because the intervention was only prayer and then to claim that the same innocuous intervention actually had profound physical effects on study patients. This is especially true since numerous claims made in previously published papers by one of the study's authors indicate that at least some of the people involved with this study believed, from the project's inception, that the intervention could have very real effects on uninformed human subjects. [10-14] Furthermore, because the study was conducted in Korea, where the majority of the population is Buddhist, Shamanist, or nonreligious, many study patients might have objected to Christian prayers as unwanted, blasphemous, or antithetical to their personal beliefs. But since the study was conducted without their knowledge or permission, the study subjects had no way to voice their objections or to opt out of the study.
I recently learned that the United States Department of Health and Human Services Office for Human Research Protections (OHRP) was apparently alerted to the absence of informed consent by the flurry of newspaper articles and television news reports that announced the Cha study's results. OHRP officials read the report and confirmed the study's lack of informed consent. As a result of its participation in the Cha study, Columbia University was investigated by the U.S. Department of Health and Human Services and subsequently sanctioned by the OHRP. Columbia University acknowledged its noncompliance with its agreement to conduct human subject research through a Multiple Project Assurance (MPA) program of the OHRP. Columbia University also acknowledged noncompliance with its own policies and procedures. Some details of this investigation are in the public domain. A letter from Michael A. Carome, MD, director of the Division of Compliance Oversight of OHRP to the vice president for health sciences, Columbia University Health Sciences Division, concerning the prayer infertility study and remedial actions can be accessed at http://ohrp.osophs.dhhs.gov/detrm_letrs/ dec01f.pdf.
5. Faith-healing studies raise patient confidentiality issues.
In the Cha study, photographs of the study patients
were obtained and circulated all over the world without
the patients' knowledge or permission. Infertility is a personal
issue for many women and circulation of their
photos by fax and mail to strangers could cause emotional
distress. Faith-healing researchers would be well
advised to become familiar with the Health Insurance
Portability and Accountability Act of 1996 (HIPAA) and
the penalties for violating this federal law.
6. Faith healing promotes guilt.
Many infertility patients believe that they are being
punished by God for some "sin" that they may have previously
committed. The implication that prayer can increase
fertility would reinforce this belief. It could also
undermine people's religious identity. Couples of other
faiths who believe the study's results might conclude that
their only hope of having a child would be to abandon
their own faith and convert to Christianity. While this
might be seen as a victory for the prayer-group participants
in the Cha study, the converts would have been
won under false pretenses if the study results were not
valid and reproducible.
7. Faith healing studies encourage acceptance of magical and
irrational thinking.
The Cha study implies that some type of supernatural
power had an effect on many of the study patients. Some
readers might believe that God or some other deity was
at work, while other readers might assume that some
type of paranormal, psychic, or otherwise magical power
worked without the need for a deity. In any case, something
beyond the laws of physics is presumed to have occurred
in this study. If the editors and reviewers of the
journal believed that the results were supported by valid
evidence, then it was appropriate to publish the study-
but odd not to offer editorial comment. On the other
hand, if the editors did not find the evidence convincing,
then it is odd that they would choose to publish the study.
8. Faith-healing studies encourage the use of intercessory prayer,
a technique that is widely used for questionable purposes.
The intercessory prayer as described in the Cha study
is similar to the intercessory prayer described in the book
Operation World: The Day-by-Day Guide to Praying for the
World. [15] This book, with more than 1 million copies in
print, describes how intercessory prayer can and should
be used to "take the kingdoms of this world for Jesus" and
"challenge self-seeking sinners and bind or remove those
who defy our God." Another popular book on prayer
techniques, with hundreds of thousands of copies in
print, explains that the fundamental purpose of intercessory
prayer is to "hasten the day of total world evangelization"
and thus complete the Great Commission of
Jesus. [16] The same book also explains how thousands of
Christian "prayer warriors" are using daily intercessory
prayer in an effort to bring millions of unsaved souls in
countries like China and Korea to Jesus. Can prayer for
healing be divorced from prayer for salvation? For what
reasons do the participants in the various Christian
prayer groups in the Cha study generally use intercessory
prayer when they are not taking part in an infertility
study? One wonders if the Christian prayer group participants,
with all the best intentions, were also praying for
the salvation (conversion) of the Korean study subjects.
Were they specifically instructed not to do so? In light of
their strong Christian faith, could they ethically honor
such a request even if it were made? Many of the prayer
group participants may have sincerely believed that God
would redeem or heal the Korean patients only if the patients
accepted Jesus Christ as their savior.
Another book on intercessory prayer preaches that prayer is "the armor for every believer . . . the weapon of our warfare . . . for pulling down the strongholds of the enemy." [17(p15)] This same book also states that Christian intercessory prayers for both healing and fertility are intimately intertwined with prayers for salvation. To many evangelical Christians it might seem senseless or even sacrilegious to pray for the restoration of fertility to infidels or people with views heretical to the Christian faith, without first praying for their salvation. In his best-selling book Healing, Catholic priest Francis MacNutt states writes that "healing is simply the practical application of the basic Christian message of salvation." [18] He also explains that "the first condition, if we seek healing, is to cast out sin" and that "what I have come to see, though, is how intimately the forgiveness of sins is connected with bodily and emotional healing. They are not separate. In fact, physical sickness is a direct sign that we are not right with God." [18(p17)] Now that it has been published in a peer-reviewed medical journal, the Cha study is certain to be used by Operation World proponents and other Christian evangelists as a compelling testimonial to the efficacy and power of intercessory prayer.
9. Positive faith-healing studies could affect public policy.
President George W. Bush's stand in favor of faithbased
initiatives has caused some Americans to believe
that the Constitutional separation of church and state is
in jeopardy. The conclusions of the Cha study may generate
interest among policymakers who favor broadening
the role of faith and prayer in the United States. In this
regard, the Cha study results are now posted on the Web
site of the National Center of Policy Analysis at
http://www.ncpa.org/iss/soc/pd100901d.html.
10. Faith-healing studies could have emotional and psychological
consequences for infertility patients.
Emotional stress combined with fear of treatment
failure can lead to serious depression in women with impaired
fertility. [19] The psychological stress may become
even more severe when all initial efforts to correct infertility
fail and IVF is required. If this method of last resort
fails, patients may lose hope and become despondent.
Because of this, some experts recommend psychological
counseling for patients who fail IVF. [20] If a patient were
led to believe that God, rather than medical conditions,
controlled the outcome of infertility treatments, then
IVF failure could have severe emotional and psychological
consequences. The already depressed woman would
be burdened with the belief that her unworthiness and/or
lack of faith had destroyed her chances for pregnancy
and childbirth. The introduction to An Intercessor's
Handbook of Scriptural Prayers states, "Prayer does not
cause faith to work, but faith causes prayer to work.
Therefore, any prayer problem is a problem of doubt-
doubting the integrity of the Word and the ability of God
to stand behind His promises or the statements of fact in
the Word." [17(p18)] In his book on healing by prayer, Father
MacNutt agrees that "lack of faith" is the number one
reason why God does not heal people and that sin is a
close runner-up. [18]
11. Faith-healing studies are self-perpetuating.
If a faith-healing study successfully makes its way
into a medical journal, its results will be used to promote
faith healing even if its methods are hopelessly flawed and
the results are not reproducible. For example, I recently
wrote a letter to the editor of Southern California Physiciancritical of their article "Prescription for Prayer" and the
claim by Larry Dossey, MD, that some 1600 studies have
revealed "something positive" about intercessory prayer.
I commented that if there were, in fact, something positive,
it certainly would not take 1600 studies to find it. Dr
Dossey's published response to my letter included the
following argument: "Controlled clinical trials and the
peer-review process continue to serve us well. The most
recent example of this process in action in the area of intercessory
prayer is from Columbia Medical School-a
positive, controlled clinical trail published in the respected,
peer-reviewed Journal of Reproductive Medicine."
[21] The flawed and possibly fraudulent Cha study
has also been cited in other journals including the peerreviewed
Journal of the American College of Surgeons as strrong
evidence for the healing power of prayer. [22]
12. Birds of a feather flock together.
Many faith-healing researchers also conduct research
on other supernatural or paranormal phenomena. Of the
3 authors of the Cha study, Kwang Cha, MD, is a doctor
from Korea who also practices in the United States and
Rogerio Lobo, MD, is chairman of Obstetrics and Gynecology
at Columbia University. Dr Lobo now claims not
to have been involved with the study until after its completion,
stating that he provided only editorial assistance.
The fact that 1 of the 3 authors now claims to have had
nothing to do with the study is disturbing. Dr Cha and Dr
Lobo both failed to respond to numerous telephone calls
and letters requesting further information about their
study. The remaining author, Daniel Wirth, MS, JD, has
a long history of publishing studies on supernatural or
paranormal phenomena, and his MS degree is in the dubious
field of parapsychology. [10-14] While doing research
for this manuscript I discovered that the Federal Bureau
of Investigation had indicted Mr Wirth, claiming that he
had conspired with ex-convict Joseph Horvath (AKA
Joseph Hessler, AKA John Truelove, AKA John Doe) to
defraud millions of dollars from the cable company Adelphia.
Mr Wirth initially denied knowing Horvath.
An Associated Press article on the indictment includes the following statement: "The FBI, in the embezzlement indictment against Wirth and John Doe, said Wirth lied when he told agents in July that he didn't know Truelove by any other last name." [23] After reading this article I reviewed my file of publications authored by Mr Wirth. These publications deal with "paranormal" or apparently supernatural phenomena, including various topics such as "distant healing" and "prayer healing." I found an article from a little-known journal that claims to be devoted to "topics outside the established disciplines of mainstream science." The journal is the International Journal of Scientific Exploration. The article is "The Effect of Alternative Healing Therapy on the Regeneration Rate of Salamander Forelimbs." The coauthors are Daniel Wirth and Joseph Horvath.
In May 2004, both Wirth and Horvath pleaded guilty in federal court to criminal fraud and to using numerous phony identities to commit felonies. Only July 13, 2004, Horvath hanged himsel in his prison cell. On November 23, 2004, Daniel Wirth was sentenced to five years in federal prison to be followed by three years of parole. He is currently incarcerated in a federal penitentiary in California.
CONCLUSION
As demonstrated in this article, there are dangers in the publication of studies that advocate faith healing. Although the Cha study demonstrates many of these dangers, the purpose of this critique is not to imply that only scoundrels conduct such studies. Undoubtedly, many religious individuals conduct faith-based studies with the best of intentions. Nevertheless, the fact remains that extraordinary claims demand extraordinary evidence. Unless replicated under strictly controlled conditions, studies claiming to have demonstrated miracle cures belong in religious magazines, not medical journals. Editors of medical journals and doctors who review manuscripts for journals should remember this obvious fact. Physicians take an oath to respect the hard-won scientific gains of those physicians in whose footsteps we walk. This is the first premise of the modern version of the Hippocratic Oath.
