Blind Faith: Richard Sloan, Ph.D

By Richard Sloan, Ph.D

There’s been a willingness in this country over the past 30 years to replace rationalism with subjectivity.

It’s a pleasure to be back before you again. I had the opportunity to speak in 1999, as Annie Laurie said, before a convention of the Freedom From Religion Foundation. I was impressed at the time with your willingness to take risks in a country suffused with a kind of a sanctimonious and increasing piety. It’s a real challenge to espouse atheism or agnosticism. But as I got to spend a little time with you and observed you, I determined that your willingness to take risks is kind of a characterological trait, because. . . . Well, it’s one thing to be an atheist or an agnostic, but I watched you throw nutritional caution to the wind by consuming a cholesterol-laden and triglyceride-laden breakfast, full of fats enough to kill an elephant!

Those of you who survived that breakfast, and are here with us tonight, may recall that I expressed concern at the time with what was then an increasing attempt to link religious practices to medical treatment. In the intervening seven years–while you may have become more nutritionally cautious–I’m sorry to say that the situation in religion and health has not improved. In fact, it’s probably worse now than it was then. As evidence of that, hardly a week or two can go by, looking at the popular media–either print media or broadcast media–without encountering some heart-rending account of a miraculous medical healing that is attributed to religious devotion.

Let’s put it this way. Since I spoke before you last, seven years ago, Harold Koenig alone has published at least four or five books on the topic. In addition to Koenig’s books, there are books by Dale Matthews on the healing power of prayer and books by Jeff Levin on God, faith and health.

And in addition to the books there are magazine articles: cover stories in Newsweek on God and health, on spirituality in America; a cover story on a similar topic in US News & World Report; a cover story on “can prayer really heal” in Parade magazine; a feature article in Prevention magazine on how religious devotion can make you almost invulnerable to disease. I’m not making this up! And that’s the popular press.

So as widespread as the interest is among the general public, unfortunately it’s shared largely within the medical community, at small and great medical centers alike. Harvard now offers on an annual basis a course organized by Herbert Benson on religion and spirituality and medicine. That’s at Harvard!

North Dakota University Medical School also has recently offered a program on a very similar topic. Duke University, one of the country’s finest institutions, and certainly one of the most productive of medical institutions, has a Center on Theology and Spirituality and Health. And George Washington University has GWISH, the George Washington Institute on Spirituality and Health.

So it’s become common within the general public and within the medical community to believe that there are health benefits to religious involvement.

One of the things that I’ve been puzzled by, and I think I now know the answer to, is: Why is this happening now? What is it about the late 20th and early 21st centuries that has led to this remarkable increase in interest? I think that there are at least five reasons, all of which are examined in Blind Faith:

Over the past 30 years, there’s been a rise in irrationalism in the United States. I don’t think it’s happened elsewhere, at least certainly not to the same extent that it has happened here. Some of you may know the work of Wendy Kaminer, a social theorist in the Boston area, who has written some wonderful books. Her treatment of irrationalism, wonderfully entitled Sleeping with Extraterrestrials, examines the topic in detail.

If you go to Amazon.com or any bookstore and look at the self-help section, the top 30 books are about the craziest topics. Dr. Dorene Virtue, Ph.D. (I don’t know what she has a Ph.D. in!), has about 100 items on Amazon. Books on angel medicine, crystal medicine, healing with fairies . . . books, tapes, CDs, mugs, greeting cards. . . . But she’s a relative piker compared to Deepak Chopra, who has over 1,000!

There’s been a willingness in this country over the past 30 years to replace rationalism with subjectivity. Kaminer does a terrific job at examining it. So that’s one reason for the rise in interest in connecting religion and medicine.

Another reason is the work of advocacy foundations which I grudgingly have to credit with being extraordinarily successful at leveraging their resources to make this point. And none of these foundations has been more successful than the John Templeton Foundation. The Templeton Foundation has supported virtually all of the high-profile researchers working in this field: Harold Koenig, Dale Matthews, Herbert Benson, all the others. They all receive Templeton support. They certainly are the foremost foundation supporting a connection between religion and health.

But there are other factors as well. One of them is a cyclical waxing and waning of religious sentiment in the United States. People refer to the succession of “great awakenings.” According to economist Robert Fogel of the University of Chicago, we are currently in the fourth great awakening. If you look at the history of the country, there have been waves of increases and decreases in religiosity in the country and it’s abundantly clear that we’re in one now.

A fourth factor is a disgracefully uncritical media. When I show slides, I show a cover story from one of the Newsweek articles, “God and Health,” and the subtitle is “Is Religion Good For Your Health? Scientists are beginning to believe.” It’s true that some scientists are beginning to believe but there still are some questions to be asked. And the media routinely, uncritically report anecdotal cases of accounts of how people became religious and as a result managed to recover in ways that nobody anticipated.

And finally, there is the widespread dissatisfaction with contemporary technological medicine. A year ago, The New York Times‘ reporter Ben Carey wrote a terrific front-page article on what he described as “the degrading shift from person to patient.” It chronicled how patients in the hospital are routinely treated, charitably, as collections of organ systems, and, a little less charitably, like pieces of meat. Cases to be poked and prodded by people who appear not to care, who have tremendous medical expertise and little else.

So these five factors, and probably many others, have led to where we are now: a widespread belief among scientists, medical practitioners, medical researchers, and the general public that religion is good for your health.

So what’s at stake? Why is this of interest? Why should we be concerned? I think a few quotes will make it abundantly clear.

What proponents of these views have in mind for us and in mind for the field is nothing less than a radical transformation of American medicine.

In 1997, Dale Matthews of Georgetown and David Larson wrote that their aim was to “tear down the wall of separation between medicine and religion.”

Matthews, in that same year, was quoted in The New York Times magazine section as saying that “the future of medicine was prayer and Prozac.”

Christina Puchalski at George Washington University recommends to all physicians that they conduct a spiritual history at each new patient visit and then annually thereafter. A spiritual history, like an ordinary physical history, or social history.

For almost any of the social ills of our day, you can find something from H.L. Mencken that is pertinent. He wrote: “For every complex problem, there is a solution that’s simple, neat and wrong.” Nothing could better capture the problems of linking religion and medicine than Mencken’s observation.

Some of you may not appreciate it, but for a great many of the people in this country, religion brings comfort in times of distress, whether it’s medically related or otherwise. You may not like it, but it happens, in fact, to be true. There are a great many people who derive comfort from religion.

The question for us is whether physicians can add anything to that, whether there is anything to be gained by bringing religion into the practice of clinical medicine. I think you can anticipate that my answer to that question is no.

So let’s look, then, at these efforts to link religion and medicine and ask three questions: Does it represent good science? Does it represent good medicine? And a question that I think needs to be asked even if you think it’s less important: Does it even represent good religion? You also can anticipate what my answers are, but I’ll leave you hanging in the balance for a few moments.

So is it good science? In one of Koenig’s many books, the voluminous Handbook of Religion and Health, sponsored in large part by the John Templeton Foundation, and dedicated to Sir John Templeton, Koenig reports that there are at least 1,200 studies on religion and health–with the vast majority showing positive associations. The book is an impressive work if you gauge impressiveness by volume.

In a previous book, Koenig reported that 77% of the studies on the health benefits of religion demonstrate a positive effect. Other studies report similarly dramatic figures. So the contention is that there are lots of studies, and the vast majority of them are positive, favorable to the proposition that religious practice is good for your health.

Are there really this many studies? What are these studies like? Well, here’s one of them that qualifies by Koenig’s standards. It was published in Psychosomatic Medicine, which is a good journal, in 1968, and the title is “Occupational Stress, Law School Hierarchy and Coronary Artery Disease in Cleveland Attorneys.” What does that have to do with religion and health?

You have to read the paper very carefully to see that one of the questions the researchers asked was, “Are you Jewish?” The authors reported differences between Jewish and non-Jewish Cleveland attorneys in the incidence of some index of cardiovascular disease. That’s it.

Here’s another one that also qualifies as one of these 1,200 studies. It was published in a less-prestigious journal, Patient Education and Counseling, and was about a weight-loss program held in a church. A weight-loss program held in a church. Now if you go beyond the Handbook of Religion and Health and actually read the paper, you discover that it’s a perfectly ordinary, garden-variety, cognitively-oriented weight-control program. It just happened to be held in a church. If it had been held in Madison Square Garden would it have been a sports-related weight-control program? If it had been held at Merrill Lynch would it have been a financial weight-control program? No. It’s a weight-control program! It just happened to be held in a church.

So that’s how numbers like 1,200 arise, because studies like this get included. We actually wanted to investigate this in a little more systematic way, so my colleague, Emilia Bagiella, and I decided that we were going to look at every study published in the year 2000 that was identified by the National Library of Medicine’s database, MedLine (the standard medical reference electronic library). We simply plugged in the keyword “religion” and looked at what came out. What came out were 266 studies published in the medical literature in the year 2000.

Then Emilia and I each, independently, read all 266 abstracts and then reconciled the few differences we had, about whether these studies were really relevant to the proposition that religious practices are good for your health. On the basis of this analysis, we determined that 17% of the 266 studies were relevant. That doesn’t mean they were good. They at least addressed the topic of whether religion was good for your health.

What were the others about? Most of them were about denominational differences: were Jews different from Christians? Were there differences between Protestants and Catholics? They were about denominational differences.

These studies may be about religion and health in the broad sense, but they have nothing whatsoever to do with whether religious devotion is associated with better health, because there was no question about whether these were religious groups or not. They were all religious. So that was one set of studies that is at least nominally about religion and health, but has nothing whatsoever to do with the putative benefits of being religious.

What other studies were there? There were studies about medical decision-making. It’s widely known that certain religious groups will not accept blood transfusions, so there were lots of studies about those kinds of issues. There were studies about religious devotion as an outcome variable, not as a putative causal variable. For example, when you receive a devastating medical diagnosis, some people become more religious and others less religious. That’s also a study about religion and health, but it’s not about the benefits of religious devotion.

So although there were a great many studies on religion and health, only a very small fraction were about this narrower topic. We then looked at the studies that were really relevant to the proposition that religious devotion is good for your health. As we reported in The Lancet paper in 1999 and in subsequent papers that we published, the vast majority of these studies suffers from significant methodological flaws. Flaws that are so serious that you can’t seriously make conclusions that there’s evidence that religious practices benefit your health.

So what are some of these flaws? There are two broad categories that I want to focus on just briefly. One of them is the failure to examine, to thoroughly rule out the possibility that other factors beside the religious ones are actually responsible for the health effect. The case in point is a study that still appears in many reviews on this topic, a study by George Comstock of Johns Hopkins University, published in 1972.

Comstock is one of the foremost epidemiologists in history. He was the chair of epidemiology at Johns Hopkins, which had the most highly regarded epidemiology department in the world. Comstock reported on data collected from 40,000 participants in a survey of residents of Washington County, Md. In this 1972 paper, he reported that people–who, six years earlier when they were interviewed, reported that they were frequent church attenders–were more likely to be alive in 1972 than were people who attended less frequently, who were more likely to be alive than people who didn’t attend at all. In other words, there was an inverse association between self-reported church attendance and mortality.

This is a very large study, examining 40,000 people. Approximately five years later, Comstock essentially retracted that finding because he realized, and to his credit he admitted, that he failed to consider one significant confounding variable, what is referred to as “functional status,” the degree to which people are well enough to get up and do things. He recognized that if you’re too sick to get up and get out of the house and go to church then a) you’re not attending church services, and b) because you’re already sick, you’re more likely to die. So rather than religious practices influencing a health outcome, it was the other way around. A health condition was influencing the capacity to attend religious services.

That’s a classic example of the failure to control for other factors that may account for the effects that are reported. To be fair, the literature has improved in the past 15 or so years, and there are studies that use more sophisticated methodological techniques to examine this issue. But I still think that the burden of proof is on the proponents and not the critics. So that’s one significant methodological problem: the failure to control for potential confounders.

The second is what junk science critic Robert Park of the University of Maryland refers to as the sharpshooter’s fallacy. Park is the author of Voodoo Science, a terrific book. He’s an ardent critic of junk science. In Voodoo Science he describes the sharpshooter’s fallacy: the sharpshooter empties the six-gun into the side of the barn, then draws the bull’s eye!

In science, this is represented by firing hypothesis after hypothesis after hypothesis after hypothesis at the side of the barn, and then saying, “There’s one that’s significant! Let’s draw the bull’s eye around it.” Unfortunately, this happens all the time and my favorite example comes from a study by Koenig and colleagues, who published a paper that so mind-numbingly violated the central tenets of science that I don’t know how it got published.

In this paper, the authors made at least 126 statistical comparisons, looking at the relationship between church attendance and blood pressure. There were three waves of data collection in this study: 1986, 1991, 1995, let’s say. And for each occasion a question was asked about, “Is blood pressure related to self-reported church attendance?” Systolic pressure, diastolic pressure, pulse pressure (which is the difference between the two), self-reported blood pressure, clinic-measured blood pressure, the relationship between 1986 and 1991, 1991 and 1995, 1986 and 1995, on and on and on. . . .

I stopped counting at 126. And the authors had the nerve to say, “The evidence is reasonably solid that religious attendance is associated with reduced blood pressure.” This is the sharpshooter’s fallacy on steroids! So the literature on religion and health is characterized by serious methodological flaws. I’m sorry to say that while they may have diminished in recent years, they have not disappeared by any means.

Here’s another illustration of a significant methodological flaw, taken from Koenig’s The Handbook of Religion and Health, and identified as a study demonstrating the benefits of religious practice for cardiovascular disease. Fifty-two male college students were taught Buddhist meditation and 30 control subjects were also studied. They were followed, and blood pressure was measured at the end of a two-month period in the summer.

What appears in The Handbook of Religion and Health sounds reasonably impressive: the 52 meditation subjects had lower blood pressure, implying that meditation was responsible for this effect. That’s all you get in The Handbook. If you read the whole paper, however, you discover that the story is considerably different. The 52 college students were not randomly assigned to engage in the practice of Buddhist meditation. They volunteered to be cloistered in a monastery for two months, where the only activity they got was walking a mile to get food every day. And they were compared to 30 college students who decided they were going to do whatever they did over the summer: work construction, work at McDonald’s, whatever. So the idea that these are two equivalent groups who differ only in that one practiced meditation and the other didn’t is just ludicrous.

I can, and I did, go on and on about the methodological failings of this literature in Blind Faith. The quality of the science simply is weak at best! And while it may be less weak today than it was seven years ago when we met, it’s by no means solid.

So, is it good science? No.

What about medicine? Is it good medicine?

In The Handbook of Religion and Health, Koenig writes, “Do religious beliefs and activities really keep one mentally or physically healthier and reduce mortality as some claim? If so, this finding has major implications for our struggling health care system.” Koenig clearly believes that our healthcare system is going to be transformed by this evidence. So we have to think about the practical consequences of what he recommends: bringing religious practices into clinical medicine. A key consideration here is the length of a typical office visit. How much time do physicians have to spend with us? Nineteen minutes is the length of the average physician visit.

I mentioned before that Christina Puchalski and many others recommend that physicians conduct a spiritual history. The history consists of four or five or six questions, depending on whose version you read. Puchalski says it takes about four minutes to administer. It may take four minutes to ask the questions; it certainly may take a lot longer to answer.

The question is: if the average visit is 19 minutes and you spend four minutes in some kind of a spiritual disquisition–more than 20% of the clinical visit–what aren’t you going to be able to do as a physician because you’ve spent these four minutes in a spiritual inquiry?

To drive that home, physicians constantly complain, as I’m sure you all know, about having too little time because of the demands of the managed care requirements, etc. In 2003, a paper in the American Journal of Public Health appeared with the title, “Primary Care: Is There Enough Time For Prevention?” The researchers examined whether physicians were able to implement the prevention recommendations by the U.S. Preventive Services Task Force. The U.S. Preventive Services Task Force evaluates prevention strategies. It looks at the quality of evidence, makes decisions about which practices are worth pursuing and which aren’t, and provides evidence-based guidelines for what physicians should do with regard to prevention.

The researchers concluded that if all of the Preventive Services Task Force recommendations were followed, physicians would spend 9.7 hours a day doing that and that alone. So when are they going to do anything else? This is just prevention.

Another study appearing a year later examined cancer screening practices in Michigan. The authors reported that despite the abundance of recommendations on what screening practices for cancer are evidence-based, and which have no evidence base, only 3% of the men and 5% of the women in these family practices in Michigan received all the recommended cancer screening.

Physicians clearly have too little time even to engage in the practices that have an evidence base. And that’s just prevention. The same is true for treatment of chronic disease. Just not enough time. Half the day devoted–according to another recent study–to managing patients with the 10 most common chronic illnesses, assuming that the patients are stable, which, of course, many are not.

So, Christina Puchalski wants physicians to spend 20% of their 19 minutes asking questions about religion and spirituality and health, for which the evidence base is extremely weak, when physicians already aren’t asking enough questions about depression, smoking, exercise, diet. That’s a very bad use of precious physician time.

There’s a subtler issue here in the spiritual history, which I want to raise with you very briefly. A few years ago, Koenig published a case report about an elderly woman who managed her chronic pain by religious practices. It’s an interesting 2-page or 3-page case report. Koenig encourages her to “Keep it up.” On the surface that seems like a reasonable thing to say: “Keep it up. It’s a strategy that works for you. Good.”

But there’s a subtler issue there. Another reason that Koenig says, “Keep it up,” is not only that it works, but that he approves of this strategy. He thinks it’s a good strategy, not only because it’s effective, but because he approves of the use of religious practices.

What if the situation were slightly different? What if the situation were, say, a young woman with Crohn’s disease who copes with the pain of that disease by gossiping with her friends? Does Dr. Koenig say, “Keep it up”?

What if a young man with rheumatoid arthritis copes with the pain of that disease by watching pornographic videos? Does Dr. Koenig say, no pun intended: “Keep it up”?

What if a man undergoing a grueling chemotherapy regimen copes by attending meetings of his favorite organization, the Aryan Nation? Does Dr. Koenig say, “Keep it up”?

The reason why I think this case merits a little bit more thorough examination is because it’s abundantly clear that Koenig is really caught on the horns of a dilemma here. Is he going to say, “Yes, I think you should keep it up. Keep going to those neo-Nazi meetings. It’s a great idea. Does it manage your chemo? Terrific idea!” Is he going to say that? I don’t think so.

The reason he’s not going to say “keep it up” is not because it’s ineffective, because it could just as well be as effective as anything else. The reason is he doesn’t approve of it. So who is Harold Koenig, or any other physician for that matter, to function as the moral arbiter of our lives?

It’s a very dangerous position, it seems to me, that’s implied by spiritual histories, and hardly anybody has considered it. I think it’s worth a thorough examination.

So there’s considerable evidence that bringing religious practices into clinical medicine is not good medicine. Other considerations, I think, also apply to this matter; significant ethical issues arise.

There are at least three such issues. The first is manipulation or coercion, the second privacy, and the third causing harm.

Let’s consider manipulation. In one of his books, Dr. Koenig makes recommendations as a physician about what his readers should do if they are not religious. He recommends that they consider attending a church or synagogue as a visitor. He recommends that they consider reading religious scripture. He recommends that they try adapting the suggestions of religious people whom they know, and he recommends trying to emulate the work of truly religious people.

These are his recommendations, as a physician, about how to reap the health benefits of religious practices if you’re not religious.

If that’s not bad enough, here are his recommendations for people who already are religious: “Consider attending religious services more frequently. Attend a prayer or scripture study group once a week. Get up 30 minutes earlier each morning and spend that time in prayer.”

Now, those may be perfectly good recommendations for a member of the clergy, but they have no business coming from a physician who is making them in the service of promoting better health. It’s simply inappropriate.

But that’s not the worst of it. A few years ago, the CBS Sunday Morning News program focused, among other things, on a Colorado orthopedic surgeon who prays with his patients. When does he pray with his patients? Does he pray with them when they come to his office to make a decision about whether or not to have surgery? No. Does he pray with them when they come to the hospital for routine pre-surgical medical testing? No. Does he pray with them when they arrive at the hospital on the day of surgery? No.

He prays with them when they are gowned and supine on the gurney. He stands over them and says, “Mind if we say a prayer?” Mind if we say a prayer! He’s practically got a scalpel to their throat, and he’s asking, “Do you mind if we say a prayer?”

Who, under these conditions, is going to say, “Well, ummm, I don’t know”?

This is not just manipulation, it is outright coercion, and it is absolutely unacceptable for a physician to take advantage of patients who are sick, fearful, in pain, and in other ways vulnerable. So that’s the issue of manipulation and coercion.

Then there’s the issue of privacy. There are any number of factors that we can demonstrate are associated with beneficial medical outcomes that we nonetheless regard as out-of-bounds for medicine. The best illustration is marital status. There is abundant evidence that being married is good for your health. People who are married live longer. The evidence is quite solid.

But we don’t expect our physicians to say, “Bob, you know, you’re a single guy. You’re 35 years old now. I just read this wonderful study about how marital status is associated with better health. I think you ought to get married.” That would be the last time Bob would ever see this physician. Because it’s completely out-of-bounds, regardless of the quality of the evidence. There are just some things that are inappropriate for physicians to discuss because they are personal and private, regardless of their relationship to health. For a great many people, religious practices are personal and private.

The third issue is causing harm.

When I began working in this field approximately 25 years ago, I was involved in a research project collecting interview data from young women who were awaiting the results of gynecologic biopsies. I was interviewing a young woman in a semiprivate room in a New York hospital. The other woman in the room also was awaiting the results of her biopsy. They were separated from each other by a very thin curtain. While I was there interviewing my patient, the family of the other woman was there and during the interview, the biopsy results for this other woman came back. They were negative. Her father exclaimed to no one in particular, “We’re good people, we deserve this.”

Now, you may chuckle, but that’s a perfectly reasonable thing for the father of a potentially sick young woman to say. But what was the young woman I was interviewing supposed to say to herself when her biopsy came back positive? Was she supposed to say to herself, “I’m a bad person, that’s why I got cervical cancer. I’ve been insufficiently devout, that’s why I got cancer”?

It’s bad enough to be sick; it’s worse still to be gravely ill. To add to that the burden of guilt or remorse over some supposed failure of devotion is simply unconscionable. But that’s what you get when you make assertions about the benefits of religious practices.

If you say that religion is good for your health, then you automatically imply the converse, that the failure to be religiously devout is a risk to you. And that is simply unacceptable.

So to review, attempts to link religion and clinical medicine are bad science and bad medicine.

What about the last matter, that they also represent bad religion?

I seriously doubt that even those proponents of connections between religion and clinical medicine with deep religious conviction and who are impressed with the data really have thought this through. What are the implications for religion of suggesting that religious activities are like consuming a low-fat diet or taking an antibiotic? Are they really the same sort of thing? I don’t think so. And I don’t think if devoutly religious people were pressed to answer that question, they would agree that they’re the same sort of thing.

This raises the issue of a field, so to speak, that has arisen over the past five or so years called neurotheology. Neurotheology. It was, of course, enshrined on the cover of Newsweek–where else?–with a photograph of a woman staring vacantly skyward, with the title “God on the Brain.”

Neurotheology represents attempts to use modern neuroimaging techniques to scan the brain during religious experiences. One of the principal proponents has written, so far as I can tell, two papers in which a total of 11 people were studied. Eight people practicing Buddhist meditation in one study and three Christian nuns engaged in devotional prayer in the other. They were imaged using a technique called SPECT scanning. These papers were published in low-level journals, leading to a book called Why God Won’t Go Away.

Both the papers and the book show the brain imaging scans of patients before and after meditation or before and after the devotional prayer. The scans are different! What a surprise! When you are engaged in meditation, different areas of the brain light up compared to when you’re not meditating.

Another paper was just published on this same topic and I was interviewed about it by a journalist from Nature magazine. I told her that I didn’t understand why this was newsworthy since we undoubtedly will see a different neural signature while people are eating cheese compared to when they’re not eating cheese! What is the big deal?

The authors of the first two papers regard these studies as revealing something fundamental about the religious experience, so much so that they give the following title to the first chapter of the book, Why God Won’t Go Away: “A Photograph of God?” They actually think that they are revealing something fundamental about the brain and religion and the nature of transcendence by showing that the brain lights up in different ways under different conditions.

In fact, Jerome Groopman, the wonderful writer and Harvard oncologist, wrote a review of neurotheology published about four or five years ago in The New Yorker. He was intensely critical of both the methodology and the theology of this effort.

To summarize, we can say not only that these efforts to link religion and medicine represent bad science, they represent bad medicine, and they even represent bad religion.

Let me conclude as I began, which is that none of us–whether we are devout or atheist–should dispute the fact that religion brings comfort to a lot of people in this country. It’s unwise to dispute that. The question for us really is whether medicine can add anything to this and, as the foregoing discussion clearly indicates, the answer emphatically is no.

There is nothing whatsoever about attempts to connect religion to medicine that in any way should transform the way in which healthcare is offered in this country. Contrary to the views of the proponents, there is just no way that this should have any impact on the medical care that we receive.

Thanks very much.

Question: Two questions. One, are the effects that are attributed to religion really placebo effects? Is that a fair question? And the second question is, are the results of some of these studies about religious practices really more about the effects of the community that religious involvement may bring with it?

Sloan: The placebo effect, while well-documented, is extremely poorly understood. I guess in one sense those two questions can be linked together. Look around you. You may not be part of a religious community, but you’re part of another community. In fact, Annie Laurie and I have had any number of conversations about how we could try to ask the question about whether the benefits that appear, and I say “appear” to derive from attendance at religious services, could be investigated in a different setting altogether, one that had nothing to do with religion, in fact one that may have to do with the disavowal of religion.

Unfortunately, while I’m very happy to hear that you have 7,500 members now, that’s just a drop in the bucket compared to your counterparts on the other team. So it’s tough to study. I am open to any suggestions that you have. It’s like you want to ask this kind of question about anarchists who by definition don’t have any organization!

My father-in-law is a retired minister. My wife’s grandfather was a minister. He had a moderately severe stroke and when he was in the hospital a colleague of his came to visit another minister and said, “I’d like to pray for you.” And he said precisely the same thing, “By all means, if it makes you feel better.”

So the question is, people report that they experience comfort from religion. Is it in fact true? I don’t really know. I don’t know of any studies that actually address it.

Question: What kind of an impact is there of studies by Koenig and others on the practice of medicine in the United States?

Sloan: I think that his studies have influenced the fact that, as Annie Laurie mentioned in the introduction, probably more than three-quarters of the medical schools in the country now offer some kind of training in religion and spirituality and medicine. I think that is directly a consequence of the proliferation of studies, whether they’re good or bad.

Richard Sloan, Ph.D., professor of behavioral medicine at Columbia University Medical Center, is an internationally known commentator on the subject of prayer and medicine. Dr. Sloan believes there are no scientific methods to accurately measure the value of faith/prayer. With Dr. Emilia Bagiella, he challenged the “health effects” of religious activity in articles in the Lancet, the New England Journal of Medicine, and the Annals of Behavioral Medicine, raising methodological failures and ethical problems. His new book is Blind Faith: The Unholy Alliance of Religion and Medicine. His research at Columbia focuses on psychological risk factors that contribute to the risk of heart disease. Dr. Sloan has been interviewed widely by media around the world.

Freedom From Religion Foundation