The long awaited Study of the Therapeutic Effects of Intercessory Prayer in Cardiac Bypass Surgery (STEP), which saw the light of day March 30 on the website of the American Heart Journal, presented Americans with the sort of news they don’t like to get. American journalists did what they could to soften the blow. 

STEP was not the first study of its kind, but it was by far the largest and most methodologically punctilious. Under the leadership of Harvard cardiologist Herbert Benson, author of The Relaxation Response and advocate of the beneficial effects of religion on health generally, investigators divided 1,802 subjects into three groups: (1) patients who were told they might be prayed for and were; (2) patients who were told they might be prayed for and weren’t; and (3) patients who were told that they would be prayed for and were.

A group of Catholic monks, a group of Catholic nuns, and a Protestant prayer ministry signed on to pray systematically for each patient to see if there might be an impact above and beyond the prayers that, it was assumed, most if not all patients would be receiving from friends and family members (not to mention themselves).

Fifty percent of all recipients of heart bypass operations normally experience some medical complication within 30 days. Going in, STEP hypothesized that Group 2 (uncertain, unprayed-for) would experience complications at the normal rate, while Group 1 (uncertain, prayed-for) would be at 40 percent and Group 3 (certain, prayed-for) at 30 percent. In fact, the hypothesis proved wrong in every respect.

The first two groups both did a bit worse than the 50 percent norm, with Group 1 (52 percent) actually experiencing a higher rate of complications than Group 2 (51 percent). Most strikingly, Group 3 did worst of all at 59 percent. In other words, the study both failed to show that intercessory prayer was therapeutic and found that patients who knew they were being prayed for were at significantly greater risk than those who didn’t. (Far from instilling Bensonian relaxation, awareness of organized prayer may have provoked “performance anxiety,” researchers later speculated.)^[1]

The results can hardly have pleased the Templeton Foundation, which backed the study to the tune of $2.4 million as part of its longstanding commitment to promoting better relations between science/medicine and religion/spirituality. Templeton’s readiness to post the study on its website despite the lack of positive results is testimony to a certain intellectual coming of age on the foundation’s part.

Not long after being established in 1987, Templeton began supporting an official sounding outfit called the National Institute for Heathcare Research (NIHR). Headed by a former National Institute of Mental Health psychiatrist named David Larson (who enjoyed a close relationship with the foundation’s eponymous founder, Sir John Templeton), NIHR devoted itself not to conducting research but to spreading the gospel of spirituality and health through educational programs and, most notably, media outreach.

A $20,000 Templeton grant for getting articles into, say, popular magazines would be collected in increments—$2,000 per article “placed.” If this incentivized philanthropic regime did not exactly result in the most objective portrayal of the available research, it certainly stimulated a lot of journalism touting the therapeutic benefits of religion.

Some of the claimed benefits were plausible whether or not you happened to be a person of faith. That belonging to a religious congregation might be good for your health could as easily be explained on sociological as supernatural grounds. But intercessory prayer looked to be another matter. If it could be demonstrated empirically that such prayer was likely to enhance one’s medical condition, even if one were unaware of it—well, wasn’t that tantamount to scientific proof of divine intercession?

STEP seemed to show the contrary, but the journalists—medical writers, for the most part—were at pains to suggest that it ain’t necessarily so.

They turned to experts in both the medical and theological communities to cast doubt on the legitimacy of trying to use science to measure religion, and to pastors and layfolk for testimony that yes, prayer, has worked for them. (The essence of this vox populi approach could be found on Beliefnet.com, which ran the Religion News Service news story on the study and then invited readers to send in their stories about how their prayers had helped others and vice versa.)

The St. Petersburg Times cut right to the chase with the headline, “Is it the prayer that’s flawed, or is it the study?” You decide.

One of the frequently cited critics was Duke University psychiatrist Harold Koenig, himself a frequent recipient of Templeton largesse, who stressed the incommensurability of science and the supernatural. “There are no scientific grounds to expect a result and there are no real theological grounds to expect a result either,” he told the AP’s Malcolm Ritter. “There is no god in either the Christian, Jewish or Muslim scriptures that can be constrained to the point that they can be predicted.”

Similarly, Daniel Sulmasy, a Franciscan priest as well as director of ethics at two New York hospitals, told the Chicago Tribune, “It seems fundamentally sinful to conceive of God as our instrument.”

Another oft-quoted expert was Columbia University’s Richard Sloan, a professor of behavioral medicine and author of a forthcoming book, Blind Faith: The Unholy Alliance of Religion and Medicine.

“The problem with studying religion scientifically is that you do violence to the phenomenon by reducing it to basic elements that can be quantified,” Sloan told Benedict Carey of the New York Times, “and that makes for bad science and bad religion.”

But bad according to whom? Registering evidence of God’s work in the world is a pretty central feature of Western religion. It was not so long ago that American evangelicals embraced the “Baconian” view that common sense empiricism would demonstrate the truths of their religious beliefs. To this day, the Catholic Church deploys scientific experts to determine whether potential saints have performed the necessary miracles.

Nor, for that matter, is it obvious that the organized intercessory prayer performed incessantly by monastic communities in the Middle Ages for the wellbeing of their benefactors took a less instrumental view of God than the STEP prayer communities. Regardless of the relevance of other factors, including the relative worthiness of the patient and of those doing the praying, it does not seem so theologically out of bounds to suppose that, as a result of all the praying, at least a few more patients would have avoided complications.

Such considerations aside, there is reason to question the unspoken assumption that STEP was really about religion at all. Back in 1998, when the study was getting off the ground, Benson told Bill Hendrick of the Atlanta Journal Constitution that he thought prayer worked “because of some unknown energy force that travels from one brain to another, even over great distances.” At least as far as the principal investigator was concerned, positive results could just as well have confirmed an hypothesis of parapsychology as of God.

As it happened, the most serious critique of the study came not from the critics in the press but from an editorial in the American Heart Journal itself. Written by three Duke Medical School colleagues, the editorial took Benson et al. to task especially for offering no explanation of Group 3’s statistically significant higher complication rate other than that it may have been random.^[2]

“If the result had shown benefit rather than harm,” the editorial asked, “would we have read the investigators’ conclusion that this effect ‘may have been a chance finding,’ with absolutely no other comments, insight, or even speculation?” By going no farther, the STEP researchers had “allowed cultural presumption to undermine scientific objectivity.” As with any other finding of negative effects from an experimental technique, it behooved them to warn future researchers of the safety issues attendant upon future inquiry into such “mechanistically undefined ‘frontier’ therapy research.”

With the exception of the Chicago Tribune’s Jeremy Manier, no reporter took note of the editorial. It fell to the on-line likes of Slate’s William Saletan and Blogcritics.org’s Anil Menon to push the interpretive envelope in uncomfortable directions—such as the possibility that the perils of intercessory prayer might go beyond clinical research trials.

As Menon put it, “Well it’s official. If you’re scheduled for a coronary bypass and the local Ned Flanders is busy organizing the congregation to pray for you, order the bastard to cease and desist immediately.”

In America, the cultural presumption in favor of prayer is pretty damn strong.