300 Spartans had the way! Frank milller: Were all spoiled.
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
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Wow... Show a smart guy one negative finding, and he makes a grandiose conclusion. Sheesh...
If you believe in the placebo effect (which BTW can be pharmacologically blocked in some cases), then you'd believe in the power of faith in healing. It's the mind-body connection. But I would expect that to be a benefit from within for the person with the beliefs rather than something that is transferred through space somehow.
It doesn't take a whole lot of work trolling through Pubmed to find some citations. I don't make a career out of following this, so I can't give you the definitive list of references. But I've read enough to understand the concept.
Here are a few teasers that took literally a few seconds to find.
I think any reasonably thoughtful person could see the probability of a negative finding in this single study you cited, Ian. A group of people pray for another person, and we expect that second person to have better medical outcomes? (a.k.a intercessory prayer or IC) I wouldn't buy it before you wrote the proposal to do the research in the first place.Ian wrote:
Funny you should mention the well designed RCT, as there's zero zilch none nada evidence of any such quality that belief in the supernatural is beneficial. As it turns out, the group that got prayer and knew it (in the only good study on prayer for healing) found they did worse
If you believe in the placebo effect (which BTW can be pharmacologically blocked in some cases), then you'd believe in the power of faith in healing. It's the mind-body connection. But I would expect that to be a benefit from within for the person with the beliefs rather than something that is transferred through space somehow.
It doesn't take a whole lot of work trolling through Pubmed to find some citations. I don't make a career out of following this, so I can't give you the definitive list of references. But I've read enough to understand the concept.
Here are a few teasers that took literally a few seconds to find.
J Pastoral Care Counsel. 2006 Winter;60(4):395-404.
Spiritual coaching in cancer patients: treating the spirit as well as the disease.
Levy RD, Chan J.
Temple Beth Emeth, 2309 Packard Rd., Ann Arbor, MI 48104, USA.
Interest in the exploration of spirituality in medical practice has been growing recently due to some studies suggesting its role in the improvement of patient well-being and quality of life. This project examined the feasibility of providing spiritual coaching with patients in an outpatient Radiation Oncology clinic setting. The purpose of spiritual coaching was to provide patients with opportunities to explore their current spiritual lives, increase their involvement in spiritually enhancing activities, and expand their spiritual opportunities. Quality-of-life measurements focused on feelings of hopefulness and distress were used in patients undergoing radiation treatment for cancer. This study suggests that there is a potential benefit for spiritual coaching in the care of cancer patients, and future studies will be done to further el ucidate the ationship of spirituality and quality of life in this population.
J Gen Intern Med. 2006 Dec;21 Suppl 5:S62-8.
An increase in religiousness/spirituality occurs after HIV diagnosis and predicts slower disease progression over 4 years in people with HIV.
Ironson G, Stuetzle R, Fletcher MA.
Department of Psychology, University of Miami, Miami, FL, USA. gironson@aol.com
BACKGROUND: Most studies on religion/spirituality predicting health outcomes have been limited to church attendance as a predictor and have focused on healthy people. However, confronting a major medical crisis may be a time when people turn to the sacred. OBJECTIVE: The purpose of this study was to determine the extent to which changes in spirituality/religiousness occur after HIV diagnosis and whether changes predict disease progression. DESIGN/PARTICIPANTS: This longitudinal study examined the relationship between changes in spirituality/religiousness from before with after the diagnosis of HIV, and disease progression (CD4 and viral load [VL] every 6 months) over 4 years in 100 people with HIV. Measures included change in religiousness/spirituality after diagnosis of HIV, religiousness/spirituality at various times in one's life, church attendance, depression, hopelessness, optimism, coping (avoidant, proactive), social support, CD4/VL, and health behaviors. RESULTS: Forty-five percent of the sample showed an increase in religiousness/spirituality after the diagnosis of HIV, 42% remained the same, and 13% decreased. People reporting an increase in spirituality/religiousness after the diagnosis had significantly greater preservation of CD4 cells over the 4-year period, as well as significantly better control of VL. Results were independent of (i.e., held even after controlling for) church attendance and initial disease status (CD4/VL), medication at every time point, age, gender, race, education, health behaviors (adherence, risky sex, alcohol, cocaine), depression, hopelessness, optimism, coping (avoidant, proactive), and social support. CONCLUSIONS: There is an increase in spirituality/religiousness after HIV diagnosis, and this increase predicts slower disease progression; medical personnel should be aware of its potential importance.
J Gen Intern Med. 2006 Dec;21 Suppl 5:S21-7.
Religion, spirituality, and depressive symptoms in patients with HIV/AIDS
Yi MS, Mrus JM, Wade TJ, Ho ML, Hornung RW, Cotton S, Peterman AH, Puchalski CM, Tsevat J.
Division of General Internal Medicine, Section of Outcomes Research, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267-0535, USA. michael.yi@uc.edu
BACKGROUND: Depression has been linked to immune function and mortality in patients with chronic illnesses. Factors such as poorer spiritual well-being has been linked to increased risk for depression and other mood disorders in patients with HIV. OBJECTIVE: We sought to determine how specific dimensions of religion, spirituality, and other factors relate to depressive symptoms in a contemporary, multi-center cohort of patients with HIV/AIDS. DESIGN: Patients were recruited from 4 medical centers in 3 cities in 2002 to 2003, and trained interviewers administered the questionnaires. The level of depressive symptoms was measured with the 10-item Center for Epidemiologic Studies Depression (CESD-10) Scale. Independent variables included socio-demographics, clinical information, 8 dimensions of health status and concerns, symptoms, social support, risk attitudes, self-esteem, spirituality, religious affiliation, religiosity, and religious coping. We examined the bivariate and multivariable associations of religiosity, spirituality, and depressive symptoms. MEASUREMENTS AND MAIN RESULTS: We collected data from 450 subjects. Their mean (SD) age was 43.8 (8.4) years; 387 (86.0%) were male; 204 (45.3%) were white; and their mean CD4 count was 420.5 (301.0). Two hundred forty-one (53.6%) fit the criteria for significant depressive symptoms (CESD-10 score > or = 10). In multivariable analyses, having greater health worries, less comfort with how one contracted HIV, more HIV-related symptoms, less social support, and lower spiritual well-being was associated with significant depressive symptoms (P<.05). CONCLUSION: A majority of patients with HIV reported having significant depressive symptoms. Poorer health status and perceptions, less social support, and lower spiritual well-being were related to significant depressive symptoms, while personal religiosity and having a religious affiliation was not associated when controlling for other factors. Helping to address the spiritual needs of patients in the medical or community setting may be one way to decrease depressive symptoms in patients with HIV/AIDS.
Explore (NY). 2005 May;1(3):186-91
Does religious activity improve health outcomes? A critical review of the recent literature.
Coruh B, Ayele H, Pugh M, Mulligan T.
Geriatrics and Extended Care Service Line, Hunter Holmes McGuire VA Medical Center and Virginia Commonwealth University Medical Center, Richmond, VA.
OBJECTIVE: Many Americans use religious activity to cope with stressful life events. Our goal was to review systematically the recent medical literature to assess the role of religion in health outcomes. DATA SOURCES: We conducted a comprehensive literature search using MEDLINE to identify studies published in the English language between January 1999 and June 2003 describing the effect of religion on health outcomes. The search strategy used the medical subject headings (MeSH) of religion; religion AND medicine; religion OR intercessory prayer; prayer; prayer therapy; religious rites; faith; medicine, traditional; religiosity; religion AND psychology; and religion AND health. STUDY SELECTION: Religious, but not spiritual, interventions were selected for inclusion. Thus, papers describing interventions such as yoga, meditation, acupuncture, and qigong were excluded. Manuscripts describing randomized controlled trials, clinical trials, and partnerships with faith-based organizations were included. DATA EXTRACTION: We found five randomized controlled trials, four clinical trials, and seven faith-based partnerships that describe the impact of religious intervention on health outcomes. Papers were analyzed by four reviewers using a modified Delphi technique to reach consensus. DATA SYNTHESIS: Religious intervention such as intercessory prayer may improve success rates of in vitro fertilization, decrease length of hospital stay and duration of fever in septic patients, increase immune function, improve rheumatoid arthritis, and reduce anxiety. Frequent attendance at religious services likely improves health behaviors. Moreover, prayer may decrease adverse outcomes in patients with cardiac disease. CONCLUSIONS: Religious activity may improve health outcomes.
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
As for the martial (NOT marital) benefit of religiosity, well this is pretty much SOP in the military and other combat circles. You really can't run RCT studies of this. It would be a tad unethical. However the issues involved aren't complicated.
Before going off to battle or to enforce the law, it makes sense to have all one's affairs in order. The last thing you want to be thinking about when you face the grim reaper is whether your extended family will do fine without you and you're prepared to make the step into the next life (or lack thereof). Any mental hesitation can be deadly.
There are quite a few references (e.g. Grossman, Laur) which I can cite on the subject.
It speaks to mindset. It has nothing to do with the "right" religion as was sarcastically suggested. It has to do with fearlessness and determination in the face of death.
One only has to look at the existence of homicide (suicide) bombers to see the extremes of human action that can be taken through belief systems.
- Bill
Before going off to battle or to enforce the law, it makes sense to have all one's affairs in order. The last thing you want to be thinking about when you face the grim reaper is whether your extended family will do fine without you and you're prepared to make the step into the next life (or lack thereof). Any mental hesitation can be deadly.
There are quite a few references (e.g. Grossman, Laur) which I can cite on the subject.
It speaks to mindset. It has nothing to do with the "right" religion as was sarcastically suggested. It has to do with fearlessness and determination in the face of death.
One only has to look at the existence of homicide (suicide) bombers to see the extremes of human action that can be taken through belief systems.
- Bill
Those are all interesting studies, of course, and again, none of them are randomized. They can't be. You can't make people believe something thay're not inclined to believe already (or, at least, its hard). So every study showing that religious people cope better with X condition are correlative. As I explained in my last post, correlation is not causation, and it always surprises me to see fact-stickler Bill embrace an association between spirtuality and health benefits. There are a number of problems:
1) Defining spirituality. I have a spritual experience whenever I connect with life (say, during an emotional moment at work where the passing of a life, or the saving of a life, or the facing of tragedy is at hand, or the occasional awe for natural wonders or just the miracle of life, like my ancient heart failure dog who quit taking his pills and started eating again somehow). I feel part of something larger and meaningful. And yet I'm an atheist. A sense of connection and purpose needs to be sorted out from supernatural beliefs. Of course having meaning and purpose might help you face illness--but it might not have to be supernatural meaning.
2) association only? Maybe the people who do better are more thankful or attribute results to higher powers? Maybe the people who are more spiritual also have better family connections, or community support. Maybe there's some other factor which increases both survival and religiosity. Maybe successful coping with illness means going to your coping response, whatever that is--and because many people are religious in this country, the ones who successfully activated their coping mechanism are overlapping substantially, in a venn diagram way, with spirituality increasers. They might be inadvertently measuring successful coping, which in the USA is expressed as religion most of the time--and religion could be less effective than secular coping, for all we know.
Intercessional prayer was cited by yours truly because it is the only better designed study of which I am aware, not because I expect prayer to work or because I think the matter closed. However,
1) it might be hard to get a lot of cooperation--religious people generally oppose further study, because science and faith are oil and water (or cynically, because they expect to come out poorly) and
2) at the same time, people all over the world believe in the benefit of prayer for the living and the dead. The evangelical movement in the USA is huge and politically powerful, and at the New Life Church in Colorado, they have a "world prayer center" devoted to this intervention. So why should we dismiss investigation of this prayer and just focus on the personal benefits? If you're a proponent of the placebo benefit, why didn't it help to know you were being prayed over? It wasn't like these patients were averse to the idea, they al consented to enroll.
Martial mindset is like the spirituality that I discussed above. Do your references show that the mindset has to embrace a supernatural faith, or is it possible that one could be devoted to a secular ideal or purpose (eg, freedom from oppression, the fight against terrorism) to achieve the martial resolve required to risk your life in combat? Can we "get our affairs in order" without a deity?
1) Defining spirituality. I have a spritual experience whenever I connect with life (say, during an emotional moment at work where the passing of a life, or the saving of a life, or the facing of tragedy is at hand, or the occasional awe for natural wonders or just the miracle of life, like my ancient heart failure dog who quit taking his pills and started eating again somehow). I feel part of something larger and meaningful. And yet I'm an atheist. A sense of connection and purpose needs to be sorted out from supernatural beliefs. Of course having meaning and purpose might help you face illness--but it might not have to be supernatural meaning.
2) association only? Maybe the people who do better are more thankful or attribute results to higher powers? Maybe the people who are more spiritual also have better family connections, or community support. Maybe there's some other factor which increases both survival and religiosity. Maybe successful coping with illness means going to your coping response, whatever that is--and because many people are religious in this country, the ones who successfully activated their coping mechanism are overlapping substantially, in a venn diagram way, with spirituality increasers. They might be inadvertently measuring successful coping, which in the USA is expressed as religion most of the time--and religion could be less effective than secular coping, for all we know.
Intercessional prayer was cited by yours truly because it is the only better designed study of which I am aware, not because I expect prayer to work or because I think the matter closed. However,
1) it might be hard to get a lot of cooperation--religious people generally oppose further study, because science and faith are oil and water (or cynically, because they expect to come out poorly) and
2) at the same time, people all over the world believe in the benefit of prayer for the living and the dead. The evangelical movement in the USA is huge and politically powerful, and at the New Life Church in Colorado, they have a "world prayer center" devoted to this intervention. So why should we dismiss investigation of this prayer and just focus on the personal benefits? If you're a proponent of the placebo benefit, why didn't it help to know you were being prayed over? It wasn't like these patients were averse to the idea, they al consented to enroll.
Martial mindset is like the spirituality that I discussed above. Do your references show that the mindset has to embrace a supernatural faith, or is it possible that one could be devoted to a secular ideal or purpose (eg, freedom from oppression, the fight against terrorism) to achieve the martial resolve required to risk your life in combat? Can we "get our affairs in order" without a deity?
--Ian
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
Not true. The third was a review article, and it cited 5 RCTs.IJ wrote:
Those are all interesting studies, of course, and again, none of them are randomized.
Ian wrote:
They can't be. You can't make people believe something thay're not inclined to believe already (or, at least, its hard).
Yes and no...
This gets complicated. But it has a lot to do with the whole mind-body connection.I'm the systems physiologist, Ian. I don't study single systems. I study how they interact, and create synergies.
I recall an interesting paper my advisor threw on my desk once. At the time, I had no idea what the hell it was about. A bunch of people were asked to mime various facial expressions. A second group was told to think thoughts related to the emotions that were supposed to be felt by the people whose faces were photographed. A third was the control. Various measurements were taken. And the verdict? You could bend the mind by bending the body.
What a concept!
You're a physician, Ian. You SHOULD know the postitive outcome benefit of having a great bedside manner, and a reassuring dialogue. At the very least, nice doctors get sued less (yes, there are references...). So even if you don't feel it, if you are a great actor then you can project it.
No rocket science there...Ian wrote:
correlation is not causation
Duke has done some rather fascinating studies on the variation in health benefits given the belief systems. A classic I can remember is the one which showed that people who believe in a punitive god have poorer outcomes than people who believe in a loving, benevolent god.Ian wrote:
1) Defining spirituality.
Should we be surprised?
No arguments there...Ian wrote:
having meaning and purpose might help you face illness--but it might not have to be supernatural meaning.
Ian wrote:
2) association only?
You're the one on the academic pedistal here, Ian. Let's do the RCT. Let's take a whole bunch of babies, and randomize them to various belief system upbringings at birth. Then let's see how they handle cancer in their older years.
Yea, right...
Ian wrote:
Maybe ....
Maybe. The only way to know for sure is to define your hypotheses and test them.
Ian wrote:
If you're a proponent of the placebo benefit, why didn't it help to know you were being prayed over? It wasn't like these patients were averse to the idea, they al consented to enroll.
Excellent question. I think I know the answer. You need to take this isolated finding of a very limited experiment in the broader context of many careful studies with both positive and negative findings.
The placebo effect requires belief. Not everyone believes, and you can't make someone believe in the short context of such a limited study. Religious training takes a long, long time. Trust me - been there, done that.
So I would argue that this design was doomed to a negative finding from the get-go. The assumption was faulty. Either that or someone with an agenda wanted to make a point. They did. Sort of...
Excellent questions. I believe you're on the right track.Ian wrote:
Martial mindset is like the spirituality that I discussed above. Do your references show that the mindset has to embrace a supernatural faith, or is it possible that one could be devoted to a secular ideal or purpose (eg, freedom from oppression, the fight against terrorism) to achieve the martial resolve required to risk your life in combat? Can we "get our affairs in order" without a deity?
What do we care the path someone takes to get there if they arrive at the top of the mountain? Who are we to dictate the path? I think that's sort of what Justin is saying.
You'd still be my friend if you liked country music, Ian...
- Bill
Brief sidenote / return to the actual topic--here's an entertaining (to me) review of 300 written by sex advice columnist Dan Savage, excerpted from his column:
"With nothing but time on my hands this week, I slipped out of the office and went to the movies. Have you seen 300 yet? It's about a handful of lightly armed ancient Greeks—the Spartans—who take on the mighty, massive Persian army. Some feel the film is homophobic; some feel it's a conservative, pro-war piece of agitprop.
Homophobic? It's Ann Coulter on a meth binge.
The Persian army is an armed gay-pride parade, a threat to all things decent and, er, Greek. The king of the Spartans—among the most notorious boy-xxxxxxs in all of ancient history—dismisses Athenian Greeks as weak-willed "philosophers and boy lovers." The Persian emperor? An eight-foot-tall black drag queen—mascara, painted-on eyebrows, pink lip gloss. Emperor RuPaul is positively obsessed with men kneeling in front of him. Why gay up the Persians? So that straight boys in the theater can identify with the Spartan king and his 300 soldiers—all of whom appear to have been recruited from and outfitted by the International Male catalog.
What isn't up for debate is the film's politics. The only times the Persian army doesn't look like a gay-pride parade in hell, it looks like a crowd of madly chanting Islamic militants. And if the Spartan king has to break Spartan law to defend Spartan freedoms? Well, sometimes a king's gotta do what a king's gotta do. Because, as the queen of Sparta points out, freedom isn't free. And, yes, she uses exactly those words. George Bush is going to xxxx x xxxx in his pants when he sees this movie."
"With nothing but time on my hands this week, I slipped out of the office and went to the movies. Have you seen 300 yet? It's about a handful of lightly armed ancient Greeks—the Spartans—who take on the mighty, massive Persian army. Some feel the film is homophobic; some feel it's a conservative, pro-war piece of agitprop.
Homophobic? It's Ann Coulter on a meth binge.
The Persian army is an armed gay-pride parade, a threat to all things decent and, er, Greek. The king of the Spartans—among the most notorious boy-xxxxxxs in all of ancient history—dismisses Athenian Greeks as weak-willed "philosophers and boy lovers." The Persian emperor? An eight-foot-tall black drag queen—mascara, painted-on eyebrows, pink lip gloss. Emperor RuPaul is positively obsessed with men kneeling in front of him. Why gay up the Persians? So that straight boys in the theater can identify with the Spartan king and his 300 soldiers—all of whom appear to have been recruited from and outfitted by the International Male catalog.
What isn't up for debate is the film's politics. The only times the Persian army doesn't look like a gay-pride parade in hell, it looks like a crowd of madly chanting Islamic militants. And if the Spartan king has to break Spartan law to defend Spartan freedoms? Well, sometimes a king's gotta do what a king's gotta do. Because, as the queen of Sparta points out, freedom isn't free. And, yes, she uses exactly those words. George Bush is going to xxxx x xxxx in his pants when he sees this movie."
--Ian
1: Perspect Biol Med. 2006 Autumn;49(4):504-14. Links
Science, medicine, and intercessory prayer. Sloan RP, Ramakrishnan R.
Behavioral Medicine Program, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA. rps7@columbia.edu
Among the many recent attempts to demonstrate the medical benefits of religious activity, the methodologically strongest seem to be studies of the effects of distant intercessory prayer (IP). In these studies, patients are randomly assigned to receive standard care or standard care plus the prayers or "healing intentions" of distant intercessors. Most of the scientific community has dismissed such research, but cavalier rejection of studies of IP is unwise, because IP studies appear to conform to the standards of randomized controlled trials (RCTs) and, as such, would have a significant advantage over observational investigations of associations between religious variables and health outcomes. As we demonstrate, however, studies of IP fail to meet the standards of RCTs in several critical respects. They fail to adequately measure and control exposure to prayer from others, which is likely to exceed IP and to vary widely from subject to subject, and whose magnitude is unknown. This supplemental prayer so greatly attenuates the differences between the treatment and control groups that sample sizes are too large to justify studies of IP. Further, IP studies generally do not specify the outcome variables, raising problems of multiple comparisons and Type 1 errors. Finally, these studies claim findings incompatible with current views of the physical universe and consciousness. Unless these problems are solved, studies of IP should not be conducted.
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"You're a physician, Ian. You SHOULD know the postitive outcome benefit of having a great bedside manner, and a reassuring dialogue. At the very least, nice doctors get sued less (yes, there are references...). So even if you don't feel it, if you are a great actor then you can project it."
Here's the thing. I never countered the importance of positive attitude. Far from it. Big fan. And I push the data you cite about sue rates on my trainees. I've spent a lot of time I didn't "have" to in supportive counseling with patients, and that's including prayer, which was not exactly easy for me to get into. My point here is that 1) supernatural beings have not been demonstrated. 2) belief in them is very hard to study, so a benefit of same is difficult to establish, but I'm aware of no solid data that supports promoting religiosity for health (trying to find those RCTs in that review you mention). 3) there's a very key other point worth noting even IF someone shows me that efforts to be religious are helpful.
"You're the one on the academic pedistal here, Ian. Let's do the RCT. Let's take a whole bunch of babies, and randomize them to various belief system upbringings at birth. Then let's see how they handle cancer in their older years. Yea, right... "
Ok, so I'm on a pedestle because I'm pointing out quality data does not yet exist? Are we supposed to promote every herbal treatment (and decline to recommend against) that MIGHT have an unstudiable health benefit?
"The placebo effect requires belief. Not everyone believes, and you can't make someone believe in the short context of such a limited study. Religious training takes a long, long time. Trust me - been there, done that. So I would argue that this design was doomed to a negative finding from the get-go. The assumption was faulty. Either that or someone with an agenda wanted to make a point. They did. Sort of..."
Well, you're arguing that the study was set up to create a placebo benefit. Actually, it was set up by religious people. Who thought they could prove that prayer would cure. If memory serves it was funded by the Templeton Foundation (I will fact check this in a wee bit). They included different groups who knew/didn't know about prayer hoping that it would show the effect (which wasn't found) was NOT a placebo effect. It was AFTER the study that religious figures saw fit to critique it.
"What do we care the path someone takes to get there if they arrive at the top of the mountain? Who are we to dictate the path?"
I had a deeply religious friend in high school and I asked her NOT to read something I'd written about the implausible stories of the Bible--she snuck it out of the pile on a desk and did so anyway, and had a crisis of faith. I don't set out to hurt people and I wouldn't stand in our troop carrier tellings people landing on iwo jima that there was no God to rescue them to an afterlife. HOWEVER, we can and should have concerns about the religions of others:
--when they promote terrorist activity.
--when they promote crazy environmental policy.
--when they try to corrupt public education.
--when they try to influence health care in unacceptable ways, from making condoms illegal to denying abortion not just electively, but for women at health risks or who were raped.
--when they try to screw with my civil rights or those of others.
--when they indoctrinate children. Yes, I think people should be able to teach their kids. But I'd like to see kids allowed to develop their minds a little before they're threatened with hell. I mean, teach your kid uechi (or offer to, when of age) but don't start at birth and tell the kid that without obeying he's going to fry in a lake of burning sulfur, right?
"You'd still be my friend if you liked country music, Ian..."
And you would still be mine. But we would have words about music on a long car trip
Science, medicine, and intercessory prayer. Sloan RP, Ramakrishnan R.
Behavioral Medicine Program, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA. rps7@columbia.edu
Among the many recent attempts to demonstrate the medical benefits of religious activity, the methodologically strongest seem to be studies of the effects of distant intercessory prayer (IP). In these studies, patients are randomly assigned to receive standard care or standard care plus the prayers or "healing intentions" of distant intercessors. Most of the scientific community has dismissed such research, but cavalier rejection of studies of IP is unwise, because IP studies appear to conform to the standards of randomized controlled trials (RCTs) and, as such, would have a significant advantage over observational investigations of associations between religious variables and health outcomes. As we demonstrate, however, studies of IP fail to meet the standards of RCTs in several critical respects. They fail to adequately measure and control exposure to prayer from others, which is likely to exceed IP and to vary widely from subject to subject, and whose magnitude is unknown. This supplemental prayer so greatly attenuates the differences between the treatment and control groups that sample sizes are too large to justify studies of IP. Further, IP studies generally do not specify the outcome variables, raising problems of multiple comparisons and Type 1 errors. Finally, these studies claim findings incompatible with current views of the physical universe and consciousness. Unless these problems are solved, studies of IP should not be conducted.
------------------------------------
"You're a physician, Ian. You SHOULD know the postitive outcome benefit of having a great bedside manner, and a reassuring dialogue. At the very least, nice doctors get sued less (yes, there are references...). So even if you don't feel it, if you are a great actor then you can project it."
Here's the thing. I never countered the importance of positive attitude. Far from it. Big fan. And I push the data you cite about sue rates on my trainees. I've spent a lot of time I didn't "have" to in supportive counseling with patients, and that's including prayer, which was not exactly easy for me to get into. My point here is that 1) supernatural beings have not been demonstrated. 2) belief in them is very hard to study, so a benefit of same is difficult to establish, but I'm aware of no solid data that supports promoting religiosity for health (trying to find those RCTs in that review you mention). 3) there's a very key other point worth noting even IF someone shows me that efforts to be religious are helpful.
"You're the one on the academic pedistal here, Ian. Let's do the RCT. Let's take a whole bunch of babies, and randomize them to various belief system upbringings at birth. Then let's see how they handle cancer in their older years. Yea, right... "
Ok, so I'm on a pedestle because I'm pointing out quality data does not yet exist? Are we supposed to promote every herbal treatment (and decline to recommend against) that MIGHT have an unstudiable health benefit?
"The placebo effect requires belief. Not everyone believes, and you can't make someone believe in the short context of such a limited study. Religious training takes a long, long time. Trust me - been there, done that. So I would argue that this design was doomed to a negative finding from the get-go. The assumption was faulty. Either that or someone with an agenda wanted to make a point. They did. Sort of..."
Well, you're arguing that the study was set up to create a placebo benefit. Actually, it was set up by religious people. Who thought they could prove that prayer would cure. If memory serves it was funded by the Templeton Foundation (I will fact check this in a wee bit). They included different groups who knew/didn't know about prayer hoping that it would show the effect (which wasn't found) was NOT a placebo effect. It was AFTER the study that religious figures saw fit to critique it.
"What do we care the path someone takes to get there if they arrive at the top of the mountain? Who are we to dictate the path?"
I had a deeply religious friend in high school and I asked her NOT to read something I'd written about the implausible stories of the Bible--she snuck it out of the pile on a desk and did so anyway, and had a crisis of faith. I don't set out to hurt people and I wouldn't stand in our troop carrier tellings people landing on iwo jima that there was no God to rescue them to an afterlife. HOWEVER, we can and should have concerns about the religions of others:
--when they promote terrorist activity.
--when they promote crazy environmental policy.
--when they try to corrupt public education.
--when they try to influence health care in unacceptable ways, from making condoms illegal to denying abortion not just electively, but for women at health risks or who were raped.
--when they try to screw with my civil rights or those of others.
--when they indoctrinate children. Yes, I think people should be able to teach their kids. But I'd like to see kids allowed to develop their minds a little before they're threatened with hell. I mean, teach your kid uechi (or offer to, when of age) but don't start at birth and tell the kid that without obeying he's going to fry in a lake of burning sulfur, right?
"You'd still be my friend if you liked country music, Ian..."
And you would still be mine. But we would have words about music on a long car trip
--Ian
Here's a review on IC from people who take their data seriously. Surprised that they tackled this twice (there were earlier reviews by them) with so many other unanswered medical questions out there, but here we are:
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000368. Links
Intercessory prayer for the alleviation of ill health.Roberts L, Ahmed I, Hall S.
BACKGROUND: Prayer is an ancient and widely used intervention for alleviating illness and promoting good health. Whilst the outcomes of trials of prayer cannot be interpreted as 'proof/disproof' of God's response to those praying, there may be an effect of prayer not dependent on divine intervention. This may be quantifiable; which makes this investigation of a widely used health care intervention both possible and important. OBJECTIVES: To review the effectiveness of intercessory prayer as an additional intervention for those with health problems already receiving standard medical care. SEARCH STRATEGY: We systematically searched ten databases (June 2005). SELECTION CRITERIA: We included any randomised trial of personal, focused, committed and organised intercessory prayer with those interceding holding some belief that they are praying to a God. This prayer should be offered on behalf of anyone with health problems. DATA COLLECTION AND ANALYSIS: We extracted data independently and analysed on an intention to treat basis calculating, for binary data, the fixed effect relative risk (RR), their 95% confidence intervals (CI), and the number needed to treat or harm (NNT or NNH). MAIN RESULTS: Ten studies are now included (n=7646). We found a slight difference between groups, favouring prayer for death (6 RCTs, N=6782, RR 0.88 CI 0.80 to 0.97, NNT 42 CI 25 to 167, I(2 )83%) but no differences between groups for clinical state, complications or leaving the study early. Individual studies did find some effects. One trial separated death data into 'high' and 'low' risk and found prayer had a positive effect on those at 'high' risk of death (1 RCT, N=445, RR 0.3 CI 0.2 to 0.46, NNT 8 CI 7 to 11). A second study found a positive effect of prayer on women undergoing IVF treatment with significantly more successful implantations in the prayer group compared with standard care (1 RCT, n=169, RR 0.68 CI 0.53 to 0.86, NNT 5 CI 3 to 10). A larger study assessed the effect of awareness of prayer and found those aware of receiving prayer had significantly more post operative complications than those not receiving prayer (1 RCT, n=1198, RR 1.15 CI 1.04 to 1.28, NNH 14 CI 8 to 50) and those uncertain if they were receiving prayer (1 RCT, n=1205, RR 1.12 CI 1.01 to 1.24, NNH 17 CI 9 to 201) AUTHORS' CONCLUSIONS: It is not sensible to interpret any of the interesting results with great confidence. However, for women hoping for successful IVF treatment there are some data suggesting a favourable outcome of prayer but these data are derived from only one of the smaller trials. On the other hand, one of the larger studies suggests that those undergoing operations may not wish to know of the prayer that is being offered on their behalf. Most data are equivocal. The evidence presented so far is interesting enough to justify further study into the human aspects of the effects of prayer. However it is impossible to prove or disprove in trials any supposed benefit that derives from God's response to prayer.
Given the very recent publication and the reputation of the source, this is highly likely to be the best analysis available on the matter, although their search was done in 2005. Data is not going to get more secure unless big news was published since. Full report not available to all but I can read it thru work connections.
http://www.mrw.interscience.wiley.com/c ... frame.html
The only comments worth noting were that the authors recommended caution about informing surgery recipients they're being prayed for, that the IVF benefit was positive but needed to be replicated and was based on scant data, and these comments about the apparently statistically significant risk of death reduction with prayer:
"2.1 Death
Overall, trial data do suggest that prayer helps postpone death and six studies (n=6784) found a slight overall effect. This result, however, does only just reach statistical significance and is markedly heterogeneous with all studies but the highly positive Aviles 2001 being equivocal. We are not confident to make claims just on this result. We think it more likely that the experimental intervention does not, on average, inflence the risk of death. More data are needed to clarify this point. Aviles 2001 separated out patients into 'high risk' and 'low risk' groups and found prayer did have a beneficial effect for high risk patients. It was not clear, however, if this separation was carried out before or after data analysis and as such no firm conclusions about this result can be made. Individually, Collipp 1969, a smaller study had the most positive effect on death. We investigated whether an uneven distribution of drugs now known to be ineffective or even toxic had occurred in Collipp 1969 as this is possible in such a small study. It did not seem to have happened. If publication bias is operating, which is likely (Egger 1995), it should be expected that small, difficult to identify 'negative' studies may exist. These would further influence the result towards the null. A caring God may not wish to prolong suffering, so death therefore might be a positive outcome of prayer."
I thought that last sentance was interesting. It implies that when God gets a prayer on behalf of the ill, he might kill them. God is to most, however, an omniscient being who already knows who's suffering. Plus, he's omnipotent, so...
Bishop Shelby Spong, in his book "Why christianity must change or die," commented how horrified he was that he was the subject of sympathetic prayers when his wife was sick (if memory serves). As he explained, the whole idea is that well known, or popular people, who get these prayers are likely to be helped, vs getting no prayer, which implies that God is swayed by popularity and might let a worthy unknown (say, a migrant farm worker with spotless morals) die for lack of intercession. He thought this was a horrrible commentary on people's idea of what God was really about.
Cochrane Database Syst Rev. 2007 Jan 24;(1):CD000368. Links
Intercessory prayer for the alleviation of ill health.Roberts L, Ahmed I, Hall S.
BACKGROUND: Prayer is an ancient and widely used intervention for alleviating illness and promoting good health. Whilst the outcomes of trials of prayer cannot be interpreted as 'proof/disproof' of God's response to those praying, there may be an effect of prayer not dependent on divine intervention. This may be quantifiable; which makes this investigation of a widely used health care intervention both possible and important. OBJECTIVES: To review the effectiveness of intercessory prayer as an additional intervention for those with health problems already receiving standard medical care. SEARCH STRATEGY: We systematically searched ten databases (June 2005). SELECTION CRITERIA: We included any randomised trial of personal, focused, committed and organised intercessory prayer with those interceding holding some belief that they are praying to a God. This prayer should be offered on behalf of anyone with health problems. DATA COLLECTION AND ANALYSIS: We extracted data independently and analysed on an intention to treat basis calculating, for binary data, the fixed effect relative risk (RR), their 95% confidence intervals (CI), and the number needed to treat or harm (NNT or NNH). MAIN RESULTS: Ten studies are now included (n=7646). We found a slight difference between groups, favouring prayer for death (6 RCTs, N=6782, RR 0.88 CI 0.80 to 0.97, NNT 42 CI 25 to 167, I(2 )83%) but no differences between groups for clinical state, complications or leaving the study early. Individual studies did find some effects. One trial separated death data into 'high' and 'low' risk and found prayer had a positive effect on those at 'high' risk of death (1 RCT, N=445, RR 0.3 CI 0.2 to 0.46, NNT 8 CI 7 to 11). A second study found a positive effect of prayer on women undergoing IVF treatment with significantly more successful implantations in the prayer group compared with standard care (1 RCT, n=169, RR 0.68 CI 0.53 to 0.86, NNT 5 CI 3 to 10). A larger study assessed the effect of awareness of prayer and found those aware of receiving prayer had significantly more post operative complications than those not receiving prayer (1 RCT, n=1198, RR 1.15 CI 1.04 to 1.28, NNH 14 CI 8 to 50) and those uncertain if they were receiving prayer (1 RCT, n=1205, RR 1.12 CI 1.01 to 1.24, NNH 17 CI 9 to 201) AUTHORS' CONCLUSIONS: It is not sensible to interpret any of the interesting results with great confidence. However, for women hoping for successful IVF treatment there are some data suggesting a favourable outcome of prayer but these data are derived from only one of the smaller trials. On the other hand, one of the larger studies suggests that those undergoing operations may not wish to know of the prayer that is being offered on their behalf. Most data are equivocal. The evidence presented so far is interesting enough to justify further study into the human aspects of the effects of prayer. However it is impossible to prove or disprove in trials any supposed benefit that derives from God's response to prayer.
Given the very recent publication and the reputation of the source, this is highly likely to be the best analysis available on the matter, although their search was done in 2005. Data is not going to get more secure unless big news was published since. Full report not available to all but I can read it thru work connections.
http://www.mrw.interscience.wiley.com/c ... frame.html
The only comments worth noting were that the authors recommended caution about informing surgery recipients they're being prayed for, that the IVF benefit was positive but needed to be replicated and was based on scant data, and these comments about the apparently statistically significant risk of death reduction with prayer:
"2.1 Death
Overall, trial data do suggest that prayer helps postpone death and six studies (n=6784) found a slight overall effect. This result, however, does only just reach statistical significance and is markedly heterogeneous with all studies but the highly positive Aviles 2001 being equivocal. We are not confident to make claims just on this result. We think it more likely that the experimental intervention does not, on average, inflence the risk of death. More data are needed to clarify this point. Aviles 2001 separated out patients into 'high risk' and 'low risk' groups and found prayer did have a beneficial effect for high risk patients. It was not clear, however, if this separation was carried out before or after data analysis and as such no firm conclusions about this result can be made. Individually, Collipp 1969, a smaller study had the most positive effect on death. We investigated whether an uneven distribution of drugs now known to be ineffective or even toxic had occurred in Collipp 1969 as this is possible in such a small study. It did not seem to have happened. If publication bias is operating, which is likely (Egger 1995), it should be expected that small, difficult to identify 'negative' studies may exist. These would further influence the result towards the null. A caring God may not wish to prolong suffering, so death therefore might be a positive outcome of prayer."
I thought that last sentance was interesting. It implies that when God gets a prayer on behalf of the ill, he might kill them. God is to most, however, an omniscient being who already knows who's suffering. Plus, he's omnipotent, so...
Bishop Shelby Spong, in his book "Why christianity must change or die," commented how horrified he was that he was the subject of sympathetic prayers when his wife was sick (if memory serves). As he explained, the whole idea is that well known, or popular people, who get these prayers are likely to be helped, vs getting no prayer, which implies that God is swayed by popularity and might let a worthy unknown (say, a migrant farm worker with spotless morals) die for lack of intercession. He thought this was a horrrible commentary on people's idea of what God was really about.
--Ian
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fivedragons
- Posts: 1573
- Joined: Thu Mar 17, 2005 7:05 am
I love this stuff.
First let's examine the fact that everyone has a left and a right brain.
There are people who operate in the right, and people who operate in the left, but every single human being has a left and a right brain.
Is there some magical voice to tell us that either way is wrong, and the other right?
Nope.
It wouldn't even matter if there was, because like it or not, the experience of being a human being includes the fact that we have a left and a right brain. It doesn't have anything to do with what we might decide is the best "course" to follow, it has been decided beforehand by some form of intelligence that we can't even comprehend that human beings should have a left and a right brain.
First let's examine the fact that everyone has a left and a right brain.
There are people who operate in the right, and people who operate in the left, but every single human being has a left and a right brain.
Is there some magical voice to tell us that either way is wrong, and the other right?
Nope.
It wouldn't even matter if there was, because like it or not, the experience of being a human being includes the fact that we have a left and a right brain. It doesn't have anything to do with what we might decide is the best "course" to follow, it has been decided beforehand by some form of intelligence that we can't even comprehend that human beings should have a left and a right brain.
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fivedragons
- Posts: 1573
- Joined: Thu Mar 17, 2005 7:05 am
So what is a deity?
To some, a deity is a personification one thousand times more strong and wise than the person who it "ifies".
To some, the word "god" is a symbol for something literally beyond human understanding, and thus unable to be personified.
Maybe we ourselves are literally beyond our understanding, as we might define understanding at this moment.
After all, we are born of something that defies definition, or at least entertains all sorts of divergent versions of the truth, the more that is "understood".
To some, a deity is a personification one thousand times more strong and wise than the person who it "ifies".
To some, the word "god" is a symbol for something literally beyond human understanding, and thus unable to be personified.
Maybe we ourselves are literally beyond our understanding, as we might define understanding at this moment.
After all, we are born of something that defies definition, or at least entertains all sorts of divergent versions of the truth, the more that is "understood".
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fivedragons
- Posts: 1573
- Joined: Thu Mar 17, 2005 7:05 am
If one looks at science as the pursuit of truth, then it is very easy to see the difference between science as a logical pursuit of the needs of the individual ego, having nothing whatsoever to do with some kind of fantastic idea of the ultimate truth.
With the science that indulges in the wildly imaginative and false search for some kind of platonic ideal of truth, without regard for the logical impetus to protect and defend the ego of the scientist and his personal window of logic.
What is truth?
We can't depend on scientists, so we'll go to the philosopher.
With the science that indulges in the wildly imaginative and false search for some kind of platonic ideal of truth, without regard for the logical impetus to protect and defend the ego of the scientist and his personal window of logic.
What is truth?
We can't depend on scientists, so we'll go to the philosopher.
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fivedragons
- Posts: 1573
- Joined: Thu Mar 17, 2005 7:05 am
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fivedragons
- Posts: 1573
- Joined: Thu Mar 17, 2005 7:05 am
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Bill Glasheen
- Posts: 17299
- Joined: Thu Mar 11, 1999 6:01 am
- Location: Richmond, VA --- Louisville, KY
As
I'm surprised that anyone would expect results from IC prayer. I'm not a fan.
But my original comment about the connection between religion and physical/psychological health holds. You're just barking up the wrong tree. IC isn't it...
You (and others) aren't getting the point. I'm ambivalent to the concept of a God, Ian. But I believe in the power of personal faith (not external prayer) for health and well being.
Ponder that a bit...
As to your list of things that religious people get wrong, well ponder the evils of several well-know secular governments such as that of the former Soviet Union as well as Communist China. Sorry... The religious don't have a corner on the market of extremism and stupidity.
By the way, your Dan Savage friend seems to have an excessive preoccupation with politics and maleness. He told me a lot less about the movie than he did about his own views.
Actually I can read his review and think maybe I would want to see the movie. It's like teenagers and the taste of the forbidden fruit, you know...
As for all the well-documented distortions, well... Cinematic license in my book. Another version done a generation from now will have a different slant on the plot.
Ever seen the movie Amadeus? Same thing... The movie pissed off my grad school advisor and chairman who was old-school Swiss and once pondered the possibility of being a professional cellist. He took the movie too literally. I totally got it. But that was my generation's perspective.
- Bill
But my original comment about the connection between religion and physical/psychological health holds. You're just barking up the wrong tree. IC isn't it...
You (and others) aren't getting the point. I'm ambivalent to the concept of a God, Ian. But I believe in the power of personal faith (not external prayer) for health and well being.
Ponder that a bit...
As to your list of things that religious people get wrong, well ponder the evils of several well-know secular governments such as that of the former Soviet Union as well as Communist China. Sorry... The religious don't have a corner on the market of extremism and stupidity.
By the way, your Dan Savage friend seems to have an excessive preoccupation with politics and maleness. He told me a lot less about the movie than he did about his own views.
Actually I can read his review and think maybe I would want to see the movie. It's like teenagers and the taste of the forbidden fruit, you know...
As for all the well-documented distortions, well... Cinematic license in my book. Another version done a generation from now will have a different slant on the plot.
Ever seen the movie Amadeus? Same thing... The movie pissed off my grad school advisor and chairman who was old-school Swiss and once pondered the possibility of being a professional cellist. He took the movie too literally. I totally got it. But that was my generation's perspective.
- Bill
Last edited by Bill Glasheen on Fri Mar 23, 2007 3:05 am, edited 1 time in total.
