In a provocative essay entitled, "Randomized God," internationally renowned psychiatrist David Healy lays out a blueprint for a clinical trial to test the healing power of prayer. Putting aside the spiritual benefits of supplication, a more pressing secular question might be phrased this way: Can strong prayer bend the medical cost curve?
Anecdotally, appealing to the Almighty offers awe-inspiring economic potential. In the Bible, both Moses and Jesus heal lepers, who are suffering from what today we would call chronic disease, while the prophet Elisha practices acute-care medicine by bringing a Shunammite woman's dead child back to life. Think what they could do with diabetes or cancer!
Unfortunately, the key element seems to be not just these healers' faith in the Lord, but also the Lord's faith in them. For example, Moses speaks to God "face to face," Jesus is God's only begotten Son and Elisha is chosen by God as the successor to Elijah. Alas, our current medical groups, hospitals and health plans are overwhelmingly non-prophet institutions.
Still, the question remains whether prayers by ordinary people can produce an equivalent clinical impact. Healy, author of books such as "Let Them Eat Prozac" and "Pharmageddon," offers a methodology for testing prayer that is no less intriguing for its firmly tongue-in-cheek underpinnings. As a scientist and progenitor of a website called Data-Based Medicine, he begins by citing three studies that have shown an effect, albeit a weak one, for cardiac patients who were prayed for versus those who were not. He then lays out a series of methodological issues for "Theo-therapeutics" more suited -- quite deliberately -- to a trial of a new drug than a trial of faith.
The first issue is who is doing the praying. For example, could stronger effects be obtained if those praying for healing were a purer population sample (e.g., children or monks)? Might Muslims, Jews or Hindus at prayer have more impact than Christians who pray and, if so, "could Christians resort to hiring Hindu Prayers while remaining Christian?" Would hospitals then have to hire accredited Prayers or risk legal liability?
Then there are the actual prayers being prayed. A careful study would look at a variety of confounding factors; e.g., the relative benefits of the more ritualized prayers in Catholicism and Orthodox Judaism versus "the more spontaneous approach found in Protestantism or Sufism." If the benefits do derive from specific prayers, "some form of patent protection might be needed for companies hoping to develop better products," Healy continues. Government or organized religion might want to patent prayer products "already in common use to ensure that the labor of millennia is not lost to the communities who did the work."
Finally, there's the delicate issue of the number of "sins" of the ill person as a possible impediment to prayer effectiveness. These could be measured in the Prodigal Son Rating Scale "to establish whether any effects occur in proportion to an individual's history of sin." Adds Healy, "We may have a real therapeutic crisis if it turns out [specific prayers and those praying] work better for sinners than for the virtuous." That kind of effect could also prompt an economic crisis, as the paradoxical "wages of sin" prompt insurers to offer lower co-pays to alcoholics and gamblers.
Given Healy's background as a pharmaceutical industry critic, his main intent seems to be poking fun at the way many physicians and patients have embraced psychotropic drugs based on studies no more sturdy than those he cites in support of faith healing. (For rhetorical purposes, he calls them "recent," but the latest is from 2001 and subsequent research has provided no confirmatory evidence for prayer efficacy.) Nonetheless, Healy's implicit call for intellectual rigor in therapeutics raises equally valid questions about the reimbursement of a whole ranger of complementary and alternative medical practices. Advocates' assertions that these are "cost-saving interventions" often owe more to enthusiasm than evidence.
In addition, Healy raises uncomfortable questions about the capitalistic nature of our health care system. If, indeed, certain prayers could be shown to shorten the course of illness, would not American religious institutions rush to patent and license them, just as many of our (non-profit) universities have done with research on the human genome? Would not these same universities hope to reap a harvest of government grants by creating what Healy calls "departments of ethnosupplicantology"?
Over the course of history, self-anointed healers have included magicians, mediums, apothecaries, barbers and priests. The archbishop of Canterbury was legally able to award medical degrees in England as late as 1840. But even in our modern era, the precise confluence of therapeutic and personal factors that causes one individual to successfully fight off disease and another to flag and fade often remains a mystery. In health care, the equivalent of the wartime plea, "Praise the Lord, but pass the ammunition" would seem to be coupling faith in providence with full funding for the Patient-Centered Outcomes Research Institute.
"God heals, and the physician sends the bill," advised an old aphorism. For now, any attempt to systematically enlist God's power to help cut that bill remains only a prayer.
A version of this blog appeared on Forbes.com.
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