Divine Intervention? A Cochrane Review on Intercessory Prayer Gone Beyond Science and Reason

1. Effects of remote,...
2. Furnishings of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial

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Furnishings of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial

BMJ 2001; 323 doi: https://doi.org/x.1136/bmj.323.7327.1450 (Published 22 December 2001) Cite this every bit: BMJ 2001;323:1450

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Hobgoblins of Consistency

Dear Editor,

"Consistency is the hobgoblin of small-scale minds" proclaimed our countryman Ralph Waldo Emmerson. By this measure out we see clearly that Leibovici, writer of BMJ's newly published study of retroactive prayer,¹ has no small-scale mind, but rather i every bit supple and expansive every bit a brontosaurus, with which he himself recently declared his analogousness.ⁱⁱ Leibovici's extraordinary intellectual suppleness is demonstrated by the new study'due south gratis-flying transcendence of Leibovici's own fervently pro-conventional argument, recently published in the BMJ, that "A deep model of the physical world is essential for choosing hypotheses to exist tested and for learning from failures."^{3 (p.1629)}

Yet we wonder about the depths to which Leibovici's mind may accept descended, fifty-fifty as we marvel at his startling methodological innovations, which allow unprecedented efficiency and rapidity in study replication. "A list of the outset names of the patients in the intervention group", he tells us, "was given to a person who said a short prayer for the well being and full recovery of the group as a whole."^{one (p.1450)} When combined with instantly available "retroactively" measured outcomes, such brevity allows the intervention to be replicated many times per hour (using the aforementioned cohort but a different randomization), especially if the prayer is extremely brusque, and patient names are provided in electronic form. Indeed, given the BMJ editor'south written report that Leibovici asked "people" (italics added)⁴ to pray for patients, pocket-size-minded skeptics might wonder if he may already accept conducted a large number of replications, not all producing equally statistically significant results. Anti-visionary or mean-spirited skeptics could argue that by employing his innovative study design, Leibovici might speedily acquit a vast number of replications - far larger than could ever be conducted in a total decade of research on virtually scientific topics, either "conventional" or "alternative", including even intercessory prayer as previously studied.

Nosotros believe that Leibovici'south radically efficient experimental design demands an accompanying innovation in reporting that is unnecessary for more conventional designs used in previous prayer studies. To exemplify responsible reporting and to facilitate future metaanalyses, we strongly urge Leibovici to offer an explicit public statement - absent from his contempo article - about the full number of times he has implemented his study design using the same patient population and database.

Leibovici deserves notice for a remarkable contribution, if not to science, to ethics, or to consistency, and so perhaps to humor, of a sort.

Doug Oman, Ph.D., School of Public Health, University of California at Berkeley, United states of america (DougOman@mail service.Harvard.edu).

Carl E. Thoresen, Ph.D., Departments of Instruction, Psychology, Psychiatry/Behavioral Sciences, Stanford University, U.s. (Thoresen@Stanford.edu)

one. Leibovici L. Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: Randomised controlled trial. British Medical Journal. 2001;323:1450-1451 (text online)
two. Leibovici L. Doctors and complementary medicine: Author's reply. British Medical Journal. 2000;320:1145 (text online).
3. Leibovici L. Alternative (complementary) medicine: A cuckoo in the nest of empiricist reed warblers. British Medical Journal. 1999;319:1629-1632 (text online).
4. BMJ Editor. Editor's selection: The BMJ takes reason's last step. British Medical Journal. 2001;323:0 (text online).

Competing interests: No competing interests

29 December 2001

Doug Oman

Lecturer

Carl E. Thoresen

School of Public Health, University of California at Berkeley (Berkeley, CA 94720-7360, Us)

Prayer Study Design

I have notwithstanding to encounter a study of intercessory prayer which includes three
groups: the unprayed for controls, the experimental group for which a
positive prayer is used (pray for adept results), and the experimental
group for which a negative prayer is used (pray for bad results).

I have been told that it would be unethical to pray for a bad consequence,
but those who so believe must presume, a priori, that prayer is
efficacious. In that case why practise an experiment?

I have been told likewise that God doesn't honor prayers for bad results.
This presumes that the person who and so believes can read God'southward mind. Why,
then, during World State of war II or other such conflicts, did so many persons
pray that the enemy would suffer bad results?

When a prayer written report is done in which the group prayed for positively
immproves and the group prayed for negatively worsens, I'll become a
believer. That seems to be the gist of this paper--- conventionalities. Some things
must be accepted on faith lonely.

No conflict of interest.

Competing interests: No competing interests

28 December 2001

Ronald 50. Fredrickson

Retired Health Professional

Domicile: 1567 Heredia Drive, Roseville, California, 95747 USA

Improbable Research

Editor,

yet once more, in your Christmas edition you publish a
contender for the Ig Nobel prize, which equally some of the
commentaries don't seem to know is awarded by the Register
of Improbable Research.

Competing interests: No competing interests

28 December 2001

Eberhard West Lisse

Obstetrician & Gynaecologist

Swakopmund, Namibia

On behalf of the "Less Sophisticated" general public

You might exist interested to note that the MSN Home page featured a
link to the BMJ article on rhythmic breathing through the repetition of
the rosary and/or mantra. By now, I'm sure that millions of members of the
general public have clicked on the available link and were able to savour
an abbreviated version of the article.

I'm likewise sure that, like me, millions of other members of the general
public went ane step further and performed a search on the words "British
Medical Periodical" and were so able to go direct to your site and
download a PDF version of the commodity so that they could read it in its
entirety. (You lot see, many of usa "less sophisticated" members of the full general
public are rather curious, and from fourth dimension to fourth dimension we do such things.)

While on the BMJ site, I took the opportunity to read the BMJ commodity
on "remote, retroactive intercessory prayer." Fascinating article!! And so,
explain to me how this matter works … are yous telling me that if I pray for
my dead Aunt Mildred, perhaps I tin get her to retroactively change her
volition to include me this time? Delight fill the general public in on how to
perfect this retroactive prayer technique. Subsequently all, "enquiring minds
desire to know …"

By the way … the general public is not amused … and we volition,
therefore, pray for you and your miserable little raisin-like souls (but
non until later, because you've convinced us that it works ameliorate that
way.) -- Margaret M. Zacny

Competing interests: No competing interests

28 Dec 2001

Margaret M. Zacny

Representative, Full general Public

USA - 46322

Confounding effects of future prayer?

Professor Martin Banal (Treat the control group) has surely said what
should be the terminal rational word on retroactive prayer.

Withal, Leibovici's example rests on our abandoning whatever a priori
assumptions about the linear nature of time. Logically, then, why has he
failed to allow for the misreckoning effects of farther, future and equally all the same
unenacted prayers on his outcomes?

Competing interests: No competing interests

27 December 2001

Prisca M Middlemiss

Medical Journalist

n/a

Freelance W3 8EJ

Science and Statistics cannot explain how prayer works

Editors - I congratulate the BMJ for the courage to publish the
articles in the Christmas edition.

I cannot understand Professor Leibovici'due south failure to acknowledge the
simple conclusion of his study. The Coincise Oxford English dictionary
defines prayer as a 'solemn request ... an entreaty to a person'. When
you make a asking or an entreaty, you lot expect it to exist honoured or denied.
In his written report, some requests that were made were answered. It is as simple
as that.

We must empathize that scientific discipline cannot excplain the workings of God
or predict the effectiveness of prayer. A animate being cannot explain its
creator. There is still a lot that is across science. There is faith and
there is miracle.

Competing interest: None

Competing interests: No competing interests

26 December 2001

Daniel O. Selo-Ojeme

Specialist Registrar, O & G

Mid Essex NHS Trust, St John'southward Hospital, Chelmsford. CM2 9BG

Re: Treat the control group

The newspaper would appear to demonstrate that one group of patients had
improved outcomes due to intercessory prayer some 10 years later. Taking
Professor Leibovici's conclusions and recommendations at face value and so
he has an ethical duty to treat the other group in a similar mode; that
this group notwithstanding experienced a poorer outcome shows that he has not and
indeed never will. Shame!

Competing interests: No competing interests

24 December 2001

Ian Spencer

Consultant Anaesthetist

UHND DH1 5TW

An example of synchronicity?

The researchers seem to assume that at that place is a linear directionality of upshot from the hereafter to the past. Information technology could be the other manner round, for instance an issue of events in the past affecting the fall of the coin used to cull the intervention and control groups. Or perhaps a more satisfy 'explanation' would exist to say that the various events are acausally only synchronistically linked. Any the nature of the links, however a fascinating study. Jung would have loved it.

Ian Guy

Competing interests: No competing interests

24 December 2001

Ian T Guy

General Practitioner

Fulcrum Medical Practise, Middlesbrough TS12 2ES

A CHRISTMAS NIGHTMARE: AN UNETHICAL Study APPROVED FOR PUBLICATION IN THE BMJ

Honey Sir,
I know that the essence of the Christmas BMJ is strangeness. Just
Leibovici's article (1) is not just strange, and not scientific, but it
is, in a higher place all, unethical. No informed consent was requested to
participants. It has no impact in clinical practice, since, fifty-fifty on the
ground of the menu by Oxman and colleagues (ii), information technology is difficult to think
virtually a retroactive consent. I contend whether a Jew would exist accepted to
participate in a trial in which a Palestinian prayed to Allah for him.

Incidentally, what about adverse events in this randomised controlled
trial?

Information technology is besides unethical for a Christmas upshot of a scientific paper.
Investigating efficacy of distant healing through clinical trial is absurd
because of the lack of a scientific rationale. Unfortunately, it is not
only the case of the Christmas issue of BMJ, because in that location is the Cochrane
review on intercessory prayer (3).

Information technology is tasteless to brand jokes on the compelling and dramatic problem
of the growing distrust in scientific medicine, which has brought to light
a lot of alternative medicine which is trying to be scientific without
having a scientific rationale. Nosotros actually did non need strangeness to exist
added to this genre. I worry about the release of such textile to the
media. Here in Italy the turnover of fortune tellers and healers is
enormous. People are turning more and more to the saints rather than to
administrators and politicians to discover solutions for a improve healthcare
management, which cannot be based on "beyond science" evidence of
effectiveness.

"Beyond science", I prophesy that the BMJ Editorial team does not
know that this is Christmas-fourth dimension, the beginning in the New Millennium, the
first of that historical period which the next generations will call the
Technological Middle Ages.

References
(1) Leibovici L. Furnishings of remote, retroactive intercessory prayer on
outcomes in patients with bloodstream infection: randomised controlled
trial. BMJ 2001; 323:1450-1451.
(2) Oxman Advertising, Chalmers I, Sackett DL. A practical guide to informed
consent to treatment. BMJ 2001; 323: 1464-1466.
(three) Roberts L, Ahmed I, Hall S. Intercessory prayer for the alleviation of
ill health (Cochrane Review). In: The Cochrane Library, Issue 4, 2001.
Oxford: Update Software.

Competing interests: No competing interests

24 December 2001

Eugenio Pucci

neurologist

U.O. Neurologia, Ospedale di Macerata, via South.Lucia, Macerata, 62100, Italy

TWO POSSIBLE EXPLANATIONS TO THE RETROACTIVE INTERCESSORY PRAYER Consequence

After reading the study by Leibovici(ane), I have considered two
competing conclusions:

a) There was actually divine intervention. In such a example, it seems
to me more plausible (information technology is more parsimonious) to suppose that, instead of
deciding the length of stay and fever duration of each patient, He did
something simpler for Him: to decide the consequence of the coin tossing
(allocating those who had longer stays in the control group). If it is the
case, there was non proper randomization and Leibovici´s study doesn't
offer anything new.

b) The other possibility is that God did not played whatever roll in this
report. Then, what I conclude is that this written report adds more reasons to remember
that p values are not only a not useful tool, as suggested in the Uniform
Requirements for Manuscripts submitted to Biomedical Journals ("Avert
relying solely on statistical hypothesis testing, such as the use of P
values, which fails to convey important quantitative information"), but a
misleading one. If you use a new methodological approach by means of which
yous show that world is cubic (not flat, not round), I would seriously
suspect that it would be improve to avoid such a method in future studies.

1. Leibovici, L. Effects of remote, retroactive intercessory prayer
on outcomes in patients with bloodstream infection: randomised controlled
trial. BMJ 2001;323:1450-1451.

2. International Commission of Medical Journal Editors. Uniform
Requirements for Manuscripts submitted to Biomedical Journals. Ann Intern
Med. 1997;126:36-47.

Competing interests: No competing interests

24 December 2001

Luis C. Silva

Senior Researcher

Medical Scientific discipline Higher Instute of Havana 11600, Republic of cuba

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