Hands Off, Doctor
by Howard Fienberg
It would be great if ... healing the sick merely required well-intentioned gestures rather than visits to the doctor. If ... well-meaning prayer or concentrated human energy could dispel human ailments. If ... only it were true.
The Annals of Internal Medicine, as noted by The New York Times, does not normally run ads for healing crystals or testimonials to the healing power of the latest herbal craze. So it seemed important when it recently published a study of alternative medicine techniques generally referred to as distance healing. Lead author John A. Astin said a review of 23 studies indicated a positive effect in 57 percent of the cases.
So distance healing works? Should we dump dialysis machines for prayer books and nursing schools for training courses in biofield therapy? Not so fast. Lets take a closer look.
Astin and his colleagues surveyed the field of medical publications, finding a small number of randomized and controlled clinical trials on human subjects in peer-reviewed journals. They then attempted a meta-analysis a review of many studies (23 in this case), hopefully on the same topic. That is where we begin to see problems with this review, because distance healing encompasses so many different concepts, including intercessory prayer (praying for another ill person), therapeutic touch (TT) (trying to alter an ill persons energy field) and dozens of other concepts like external quijong and mental healing. Proponents of each have different methods and claims, so lumping them together in one review may not be the best research tool. Meta-analytic comparisons tend to be unreliable because the studies examined usually use different techniques, questions, assumptions and types of test subjects.
Astin and his colleagues admit that a proper meta-analytic approach was considered but was abandoned due to all these reasons. Nonetheless, effect sizes averaged across each category of distant healing were included in an effort to provide some quantitative measure of the magnitude of clinical effect. In short, meta-analysis seemed unwise, but they did it anyway.
Because of the problems with meta-analysis and because the authors admit that some of the studies were not top notch, knowing that 57 percent of 23 studies showed at least one positive impact tells us nothing. But is there anything to distance healing treatments anyhow?
TT is based on the assumption of a human energy field extending beyond the skin for several inches. In theory, a trained expert can sense and manipulate this energy field. Nine-year-old Emily Rosa put TT to the test in 1996 when the Journal of the American Medical Association (JAMA) published her double blind experiments. She tested 21 practitioners numerous times to determine whether they could detect one of her hands near their own while their view was obstructed by a cardboard screen. These experts detected Emilys hand only 44 percent of the time no better than guessing. TT failed this simple test. Emily Rosa was the youngest researcher ever published in a major medical journal and JAMA editor Dr. George Lundberg concluded that patients should refuse to pay for TT until or unless additional honest experimentation demonstrates an actual effect.
Intercessory prayer may make good spiritual sense, but if it works we may never know. Proper trials require both a set of patients to receive prayer, and a control group to receive no prayer at all. Once you ensure that each patient is identical and is not receiving any other medication, you then must ensure that no one else is praying for a patient in the control group. Even in the case of a homeless old man with no friends or family, there will almost certainly be someone, somewhere, praying for him. This eliminates the possibility of a controlled experiment.
We have little scientific evidence to explain how or if alternative medicine from gingko biloba to coffee enemas actually improves human health. The growing number of users of alternative medicine shows our need for credible research, but studies like Astins do not aid our quest for knowledge, they only obscure it.
Most ill people improve on their own and their illnesses are often undefined, rarely fatal and do not tend to deteriorate in a straight deleterious pattern. Medicines and methods might appear to be effective, but discerning their real effect is difficult. The biggest confounder is our selection-bias in remembering anecdotes. While we remember specifically that Johnny got better after we prayed for him, we will forget that Jane died after we prayed for her.
This does not mean we should stop caring or praying, nor should we forbid others from pursuing such avenues. However, we cannot accept treatments lacking in a sound scientific basis as medicine. They should not be taught in medical schools or accredited by medical boards. Doctors and nurses should focus on medicine rather than playing with their patients energy fields.
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