NOTE: THESE SUMMARIES ARE OF HISTORICAL INTEREST ONLY AS THE REFERENCED COCHRANE REVIEWS ARE NOW OUTDATED
INTERCESSORY PRAYER FOR THE ALLEVIATION OF ILL HEALTH
Intercessory prayer is organised, regular and committed, where a person or group set time aside to communicate with God on behalf of another who is in some kind of need. It is practised by people who hold some committed belief that they are praying to God. Recipients of intercessory prayer may not know that they are being prayed for.
Other forms of prayer include organised prayer to God based around an advanced belief system, individualised sporadic prayer, spiritual healing, meditation and thanksgiving. Prayers can be spoken from within the framework of a variety of faiths and also by those who do not ascribe to a particular, formalised belief system.
What is known
Praying is an ancient custom. Prayer is widely used by people for good health and to overcome illness and ease suffering. The consequences of divine intervention may be subtle and not easily identified, which makes measurement of the effectiveness of prayer. Prayer may also have an effect that is not dependent on divine intervention and that is measurable, trials on the health outcomes of prayer are not about ‘proving’ that there is a God who responds to our prayers.
Intercessory prayer by people outside the healthcare surroundings is personal, focused and committed to pleading on behalf of another. This review considered trials in which organized prayer, in addition to the standard care, was compared with the relevant medical and non-medical care normally given to people diagnosed with the particular illness. The people praying held some religious belief that they were praying to a God with the intent of aiding people’s recovery.
What the synthesised research says
For women hoping for successful IVF treatment the findings of the one trial involving 169 women suggested a favourable outcome of prayer after four months of IVF treatment. Clearly more women had more successful implantations in the prayer group compared with standard care. Five women had to receive prayer for there to be one extra implantation (NNT 5, range 3 to 10). Participants and clinicians were unaware of the trial and its results.
In varying life-threatening conditions (6 trials with 6782 participants), the number of deaths was reduced amongst those receiving prayer (RR 0.88, 0.80 to 0.97). One trial separated death data into 'high' and 'low' risk cardiac patients and found prayer had a positive effect on patients at 'high' risk of death (445 patients, NNT 8 (range 7 to 11)) but not the low risk patients.
Looking at general clinical state (5 trials, 2705 people), no effects of prayer were apparent for readmission to the coronary care unit (4 studies) or hospital (1155 people) or visits to an emergency department (2 trials, 1789 people). There were no clear differences in complications during treatment; or the number of people leaving the study early (8 trials, 7038 people).
How it was tested
The review authors made a thorough search of the medical literature and identified ten controlled trials randomizing a total of 7807 people. Seven of the ten included studies involved people who were 'acutely ill' with life-threatening conditions: children with leukaemia, people admitted to a coronary care unit (five trials) and people with a blood stream infection. One small trial involved women undergoing in vitro fertilisation (IVF) treatment for infertility and participants in the remaining trials were ill with psychological or rheumatic disease or under treatment for alcohol abuse.
Some participants were prayed for by groups (four trials including the awareness trial), others by individuals who were unknown to the patients (six trials including the IVF trial).
The participants of three trials were not aware that they were in a trial, so that it could not influence the results (blinding). In one of these trials neither did the people praying know. Written consent was not obtained in a further two trials.
Side effects and general cautions
One trial set out to investigate the extent to which knowing that one is being prayed for influences recovery. The results suggested that those undergoing operations may not wish to know of the prayer that is being offered on their behalf.
In this trial cardiac patients were prayed for over 14 days, starting the night before coronary artery bypass surgery. Some participants were specifically informed that they were receiving intercessory prayer from people other than 'friends and family' and consent was obtained. They did not fare clearly better over 30 days than those receiving ‘standard care’ on number of deaths, clinical state, readmission to the coronary care unit and leaving the study early (1198 patients). Looking at post-operative complications, they actually had more than those not receiving prayer (RR 1.15, 1.04 to 1.28; NNH 14, 8 to 50). A similar pattern was seen comparing awareness of prayer versus uncertainty of prayer (1205 patients) where those in the 'uncertainty of prayer' group were told they may or may not be the focus of intercessory prayer (and were favoured with fewer post-operative complications.
Everyone is the recipient of prayer as devout or religious people pray in a general way for those in the world who are sick and suffering, which may confuse both control and intervention groups in a trial.
Meditation, distance healing and non-contact therapeutic touch prayer were not included in this review as they can be considered not to be direct pleas to God for another’s recovery or successful healthcare intervention.
A caring God may not wish to prolong suffering, so death might be a positive outcome of prayer.
Roberts L, Ahmed I, Hall S. Intercessory prayer for the alleviation of ill health. The Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD000368. DOI: 10.1002/14651858.CD000368.