Does science prove prayer works?

Religion is the "forgotten factor" in modern medicine.  Many patients have deeply felt, but unmet religious beliefs and concerns, which may directly influence their health and medical care. Primary care practitioners frequently encounter spiritual issues in their daily work, but many do not recognize or choose to address these issues as part of their clinical approach.  However, the pressing needs and interest of patients in this domain, and a growing body of empirical research demonstrating the health benefits of religious commitment suggest the value in changing one's approach: clinicians who champion comprehensive clinical care and who wish to meet needs of the "whole person" must consider extending the scope of their practice by addressing religious and spiritual matters when necessary.

     The relationship between religion and medicine is not new: these disciplines represent the twin traditions of healing since antiquity.  With the dawn of the Scientific Revolution, however, a "wall of separation" was built between medicine and religion.  The introduction of scientifically-based treatments brought remarkable healing to many persons. Yet, the persistence of chronic illnesses and reappearance of old scourges in the face of spiraling technology and scientific achievement has tempered previously-held confidence that science will inevitably solve the mysteries of  illness. A new willingness to consider alternative perspectives on healing has appeared. It may be a fruitful and opportune time to consider the reunion of these twin long-separated traditions of healing.

     Americans are highly religious and frequently participate in religiously-based healing activities. Many patients want their religious beliefs and practices respected and their spiritual needs acknowledged as part of their medical care. The spiritual needs and religious practices of patients are great in times of illness. Studies have found that between one-half and two-thirds of patients wants their doctors to pray with them.

     Are religious commitment and religious practices beneficial to health? If so, should medical practitioners, who are professionally responsible for promoting health among patients, be encouraging patients to practice religious beliefs to enhance their health status?

     The principal domains of influence for religion upon health include substance abuse, mental illness, quality of life, medical illness, and survival. For example, religion appears to have a role in the prevention and treatment of cancer. In other studies of coping among patients with cancer, highly religious people with cancer had increased life satisfaction and happiness and diminished pain and anxiety than less religious cancer patients.  Patients with heart disease have been found to benefit from religious and spiritual interventions. Worship attendance has been linked to lower blood pressure in several studies. Persons with strong religious commitment have been found to live longer. Finally, religious commitment appears to be beneficial among patients recovering from surgery.

     The most carefully-designed longitudinal cohort studies generally find a significant relationship between religion and medicine.  The more difficult questions are whether the medicine-religion link is valid and causal. There are important confounders, including heredity, health practices and behaviors, psychosocial effects associated with the development of community and engagement in meaningful ritual, and measurable physiologic effects from worship and prayer. There needs to be further studies, particularly longitudinal, cohort studies of different populations and religions, and randomized, controlled studies of prayer and other spiritual interventions.

     How do we bring this data back to the clinical setting? I believe that the medical value of faith is not a matter of faith--but of science. The scientific evidence of the health benefits of religious practice justifies its consideration in medical practice.  First, all clinicians can acknowledge the impact of spirituality, inquire about religious matters, and even encourage faith and religious practices among their patients, even if they are not personally religious. Clinicians can acknowledge the impact of religion and spirituality very simply, by inquiring about them in a routine manner. I encourage the development of an integrated approach to faith and religious practice among those patients who appear interested in such an approach.  Practitioners can, and should refer to clergy.  Some clinicians may become expert themselves in certain aspects of spiritual counseling. Finally, the national polls have identified an interest among the general public in having one's doctor pray as part of medical treatment in certain instances. Prayer for patients and with them is a potent and meaningful option, depending on the belief systems and comfort levels of the patient and doctor with that practice.

     Further research is needed to indicate which clinical situations will be most responsive to spiritual intervention as an adjunct to medical care. I do not recommend, or condone an "either/or" approach: using faith-based approaches alone or excluding faith issues from one's medical approach.  Clinicians need not, and should not replace clergy: their roles are distinct, and both are needed in the care of the suffering.  Prayer is a not a panacea that should supplant Prozac, Prednisone, Premarin, or other preparations. A better approach is "prayer and Prozac!": faith and medicine, as needed in individual situations. Use of prayer and authentic religious commitment are not a guarantee of health.  Patients need not, and should not follow "doctor's orders" in matters of religion.  They don't follow our orders anyway! Even though all religions probably have similar medical effects, I am not saying that all religions are the same. Religions are, in fact, very different and has divergent views on the understanding of the human condition, questions of suffering, and the possibility of life after death. The choice of one's religion should be based on  personal and family considerations and theological concerns, not out of hope that one religion offers a greater likelihood of obtaining health benefits than another.

   I do believe that physicians can and should encourage patient's autonomous religious activity, and that clinicians of the twenty-first century will join with clergy to develop a new synthesis of scientifically-based and religiously meaningful medical interventions to help persons who suffer and seek our aid.

Dr. Dale Matthews is available for speaking engagements also.  Please click here for contact.

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