Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial
BMJ 2001; 323 doi: https://doi.org/10.1136/bmj.323.7327.1450 (Published 22 December 2001) Cite this as: BMJ 2001;323:1450
All rapid responses
The staff at the BMJ, and discerning readers, may be amused by this
article demonstrating yet again the truth of Disraeli's aphorism about
'lies, damned lies and statistics'. That this is already accepted as
evidence for the existence of God by one of your correspondents, and will
doubtless be quoted by endless purveyors of religion and quackery,
indicates that what may be entertaining to the informed reader is easily
used as wool to pull over the eyes of the less sophisticated. Does the
editor of the journal not have some responsibility to the wider public to
point out the logical paradox in the paper?
A second, cross-over trial can be performed in which the control
group becomes the experimental group and is prayed for. Should the results
of the second trial demonstrate that the new experimental group have
retrospectively improved outcomes then that really would be a breakthrough
in the study of the existence of the non-material world. Thus God would
have been shown to exist and one could return to a comforting Universe
where a paternal, loving anthropomorphic being gives us protection from
reality. And fairies would take up residence at the bottom of my garden.
Competing interests: No competing interests
I suggest to treat the same group of patients inverting the study
group and the control group. Any change in the outcomes would provide a
clear evidence of the effect of the treatment. In other words I would pray
for the other patiens too, to see if their previous hospital stay
shortens.
I also suggest to try to prove a dose-related response to the treatment;
as there is no known adverse effect of the treatment it would be possible
to use extreme doses (few seconds of prayer for multiple patients versus
hours of prayer for a single patient).
I would send a copy of the original paper for the IgNobel price of next
year becaouse I suspect the it is the princpal aim of the author.
Competing interests: No competing interests
It was very brave of both the author and the BMJ to publish this
paper in a scientific journal and be prepared for the inevitable criticism
from the outraged masses. The idea that retroactive intercessory prayers
could have an influence on the outcome of septicaemia is intriguing and
challenges our notions of cause and effect.However, if it is true, this is
not the paper to prove it. The data on the the most significant
finding,length of stay, appears to be skewed by a few abnormally high
results in the control group.This is demonstrated by the fact that the
median length of stay is the same in both groups but the maximum length of
stay in the control group is twice that in the intervention group. This
may represent a type I statistical error,despite the large sample size.
From a cynical stand point, it is a shame that God cannot save your life
but might get you out of hospital a few days earlier.Either way, it was a
thought provoking paper but may just prove the power of statistics, not of
prayer.
Shehan Hettiaratchy MA FRCS
Carolyn Hemsley MA MRCP
Competing interests: No competing interests
According to Clause 30 of the latest revision of the Declaration of
Helsinki:
At the conclusion of the study, every patient entered into the study
should be assured of access to the best proven prophylactic, diagnostic
and therapeutic methods identified by the study.
To meet this ethical standard, the prayer should now be said for the
control group. If the treatment is effective, this should have the effect
of removing the difference between the groups. I await the results with
interest.
Competing interests: No competing interests
Congratulations Dr Leibovici
This is - a first Evidence of Providence Based Medicine
Competing interests: No competing interests
Dear Richard,
As any student of Star Trek will tell you, the first rule of time
travel is that you cannot change the course of history, otherwise you get
into an infinite regress.
In the case of Leibovici's study, if we accept that people can be
made better by future prayer or other intervention then must have been
made better at the first time of that intervention, when they were ill.
In which case it would then be impossible for them to be subsequently
allocated to the placebo arm of the study.
That means this paper is not a randomised controlled trial.
But then you knew that already !
Yours sincerely,
Dr John Hopkins
Competing interests: No competing interests
Sirs,
I appreciate almost absolutely, without reserve, except one, ethical in
nature, the conclusion of the intriguing Leonard Leibovici’s paper about
effects of remote retroactive intercessory prayer on outcomes in patients
with bloodstream infection in randomised controlled trial (BMJ
2001;323:1450-1451, 22-29 December ). Author’s conclusions state that
remote, retroactive intercessory prayer is associated with a shorter stay
in hospital and shorter duration of fever in diseased individuals.
Therefore, its use in clinical practice should be considered, according to
other articles conclusions, as regards beneficial effect in patients in an
intensive coronary care unit, to which I dare add my recent, personal case
(Last 9 July, at 5 hours a.m., I was involved by acute myokardial infarct,
recognized forunately early – as “impending infarction” – , with the aid
of Biophysical Semeiotic (http://digilander.iol.it/semeioticabiofisica),
so that, when AMI ocurred,followed by cardiac arrest due to ventricular
fibrillation, the car, driven by my young daughter was near the emergency
room of our hospital, where my wife and skilled colleague were waitng for
me.
At first, I do not consider the “particular” condition of the
retroactivity of intercessory prayer on outcomes in patients diseased with
infection, due to the fact that knowledge of God is “instantaneous”. We
can explain the prayer favorable influence on diseases outcome, either
with extrasensory forces or with the existence of God. But does God really
exists? In my opinion, scientist’s answer would sound “yes”. As a matter
of fact, we scientists are, all life long, searching for truth, but know
without any doubt that we reach exclusively “scientific” truths or,
speaking in other words, temporary truth. Therefore, we are at a cross-
roads: either the Truth does not exist (and we scientists are crazy
dreamers), or there is “Esse per Se Ipsum”, Who have “constitutive and
eternal” knoweledgement of truth, namely in an absolutely different way,
the men are laking, since our knowlegement is “external, attributive,and
thus transient” , while the former one is “Love, as knowledge
sublimation”, according to Saint Gregorious from Nisc, VI century a.D.
Competing interests: No competing interests
I would like to know how many readers believe in this nonsense paper.
The research methodology was poor, non scientific and the results were
most probably biased by the author's own belief.
Competing interests: No competing interests
A double blind, controlled study that proves a divine intervention?
May be this is an oversiplification of the results of this study, but
that's what it seems - the authors prove that there is a God. This is done
by using a proven and proper study methodology. However, what about the
pupose of the study? This should be defined prior to the rest of the
research. How can one intend to prove an association with an unexplainable
factor? If there is a God and wanted us to know (opposed to beleive) about
it, he/she would find a way. If there is not - well there's always type 1
(alfa) error.
Competing interests: No competing interests
Occam's razor
EDITOR - When assessing the effects of retroactive
intercessory prayer, Leibovici (1.) fails to take into
account Occam's razor, according to which 'It is vain to
do with more what can be done with fewer'. (2.) It is
more parsimonious to assume that there is some
methodological problem, or even that the results are
attributable to chance (despite the quoted confidence
limits), than to accept that a short prayer said by one
person for persons unknown except by name can affect
the outcome of a set of events several years previously.
Also in the discussion section Leibovici refers to
retroactive prayer being 'associated with a shorter stay
in hospital' and later he says 'no mechanism known
today can account for the effects [of retroactive prayer]'.
An association is not the same as an effect, which latter
term implies causality. Even if there is an effect,
Leibovici's paper does not provide evidence of a causal
link.
1. Leibovici L, Effects of remote retroactive intercessory
prayer BMJ 2001; 323:1450-1 (22 December)
2. Occam, W (1300-1350 CE) quoted in Russell B, A
history of western philosophy, Unwin 1984:462-3
Competing interests: none.
Competing interests: No competing interests