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Many people might think this is okay –

Community nurse Caroline Petrie, 45, says she asked an elderly woman patient during a home visit if she wanted her to say a prayer for her.

I don’t. Nor would most health care professionals, religious or not. And unlike others who have blogged on this, I have the guts to leave my comments open.

A health care practitioner works in a hospital to provide one thing – health care. This can range from medical therapy to a good bedside manner. But offering religious services is outside any health care provider’s purview. Prayer is not a part any standard of care that I am aware of (and I have worked in a hospital setting). Such intercessory prayer has been extensively studied, with the largest (the STEP1 and MANTRA2,3 studies) showing almost no effect whatsoever. I say ‘almost’ because the STEP paradigm was of a clever design and was able tell show that people who knew they were being prayed for actually had worse outcome.

If you look using Pubmed using the search term ‘intercessory prayer’ you will indeed find published papers supporting a positive effect of prayer. Interesting, you might think. That is, until you take a look at the quality of journals that these papers are published in, such as the Journal of Alternative Medicine. Publications such as these are known as ‘bottom-feeder journals’, journals willing to publish any piece of crap which comes across the editor’s desk and often without peer-review. Researchers try very hard to get their work published in the most cited journals, and if this is the best they can do you can be pretty sure the content isn’t worth its equivalent in toilet paper. 

So, it has been pretty well established that Petrie’s actions are very unlikely to have any positive effect. Even so, she defends her actions –

“My faith got stronger and I realised God was doing amazing things in my life.

“I saw my patients suffering and as I believe in the power of prayer, I began asking them if they wanted me to pray for them. They are absolutely delighted.”

I have no doubt that many may very well be quite happy to be prayed for. It is, however, irrelevant. Soliciting such ‘indulgences’, whether for free or not, is outside any standard of care. It’s simply not allowed. If the patient has spiritual needs, professionals are available to handle these needs and in such a case the health care worker should refer such people to them. 

What’s the harm, you might ask? If prayer does nothing, then nothing is lost. But this is not so. Medicine, and Science in general, needs to keep the wolves at bay. There are doctors out there that believe medicine will be reduced to ‘prayer and Prozac’.4 This is scary stuff. If we allow health care practitioners to introduce unproven techniques into the standard of care, why not have a hospital where the only therapy is prayer? Why not a homeopathy hospital? This spiritual crap will erode evidence-based medicine to the point where MDs will be no more than members of the ‘Brylcreem set’ with lab coats. 

Indeed, Petrie’s actions impacted on her patient’s welfare – the patient was upset enough to make a complaint. Simply put, Petrie acted improperly and unprofessionally, and the hospital took the appropriate action –

A spokesman for North Somerset Primary Care Trust said: “Caroline Petrie has been suspended pending an investigation into the matter.

“She is a bank nurse and has been told we will not be using her in this capacity until the outcome of our investigation is known.

“We always take any concerns raised by our patients most seriously and conscientiously investigate any matter of this nature brought to our attention.

“We are always keen to be respectful of our patients’ views and sensitivity as well as those of our staff.”

Alison Withers, Mrs Petrie’s boss at the time, wrote to her at the end of November saying: ‘As a nurse you are required to uphold the reputation of your profession.

‘Your NMC (Nursing Midwifery Council) code states that “you must demonstrate a personal and professional commitment to equality and diversity” and “you must not use your professional status to promote causes that are not related to health“.’ [Emphasis mine.]

Had this not involved religion (and Christianity, at that) we would have heard nary a peep. Had it been a witch doctor asking if he could do an animal sacrifice for the patient, would that still be okay? To a Christian it may seem to be a different situation (I suppose it is for the chicken), but it isn’t.

I have no doubt that Petrie’s actions were well-intentioned. But that is irrelevant. Being a member of a widely followed religion does not give her carte blanche to overstep her bounds as a health care provider. The hospital is correctly taking the matter seriously, and Petrie completely misses the reason why. This is not, as pundit Melanie Philips writes, “how society dies”. The religious are not being persecuted. This is about professionalism in providing medical care. There is no right to convert people, yet try to take a religious person’s perceived and imaginary right to cram their beliefs down everyone else’s throat and just listen to the wailing and gnashing of teeth! I’ve never figured out why the religious are surprised when those of us who do not share their beliefs get upset at the assumption that we non-believers will validate their own just because they are religious beliefs. As Sam Harris has said, we do not condone stupidity unless it is religious stupidity. And this nurse allowed her religious beliefs to override the standards of conduct of her profession and those of the hospital she worked in. As PZ Myers quipped when he was in Calgary ten days ago, religion should be like masterbation – it makes you feel good, should be done in private and should not be a requirement in running for public office.

How is it that the patient in question, 79 year old May Phippen, gets it – 

‘I have Christian beliefs myself and maybe she meant well. But it could perhaps be upsetting for some other people if they have different beliefs or thought that she meant they looked in such a bad way that they needed praying for.’

when Petrie completely misses something which should be second nature to her?

I am not for firing this woman. Nurses are important people and we need more of them. But it should be made abundantly clear that this is not acceptable. At the hospital, she is a nurse, not a priest, and should act in a manner befitting the former rather than the latter. Perhaps a course in medical ethics might be a good thing to order her to attend. What bothers me is that many people miss the point of what is going on and attribute it to religious persecution instead. No one is attacking Petrie’s freedom of religion. But religion should be personal, particularly in such a workplace as a hospital. I think even wearing a cross at work is gauche and I do not wear my scarlet ‘A’ at work either.

Petrie was suspended without pay since December 17, and is expecting a decision following a disciplinary hearing next week.

(With thanks to PZ Myers for the original post on Pharyngula.)

References:

  1. Benson H et al. Study of the therapeutic effects of intercessory prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer. American Heart Joural 151:934-42 (2006)
  2. Krucoff MW et al. Integrative noetic therapies as adjuncts to percutaneous intervention during unstable coronary syndromes: Monitoring and actualization of noetic training (MANTRA) feasibility pilot. American Heart Joural 142:761 (2001)
  3. Krucoff MW et al. Music, imagery, touch, and prayer as adjuncts to interventional cardiac care: the Monitoring and Actualisation of Noetic Trainings (MANTRA) II randomised study. Lancet 366:211-7 (2005)
  4. Sloan RP. Blind Faith: The unholy alliance of religion and medicine. St. Martin’s Griffin, 2008
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10 Comments

  1. “I have no doubt that Petrie’s actions were well-intentioned.”

    I however do doubt it. I think PZ said it best:

    “If the nurse were sincere in her faith, there’s something very easy she could do. Don’t ask, just go quietly off by herself and pray for the patient. The request is an unnecessary element that is little more than a ploy for attention, a declaration of her piety.”

    Asking the patient if she could pray for her is superfluous – why would she need the patient’s permission? It’s just a way for her to advertise her faith and coerce the patient, a from of proselytization.

    This reminds me of this week’s episode of House (I know you don’t watch it, but you really should. He says so many things that I agree with, that you don’t hear characters on TV saying anywhere else). He said that people only do things that serve their own self-interest (paraphrasing). This parallels an axiom I have been touting for years – that there is no such thing as an unselfish act. I have softened a bit on that lately, as I think there are possibly one or two acts that may be considered truly altruistic (from a social, but perhaps not not biological, perspective).

    But I digress… back to the nurse. The ineffectiveness of intercessory prayer aside, I think the only issue here is with the inappropriateness of her actions. I will concede that there is a place for religion in medicine, since many patients are religious, and there is likely a psychological benefit to the patient. That’s why we have sugar pills – placebos can be effective. However, this is why we have hospital chaplains. And a patient should only be offered religious services IF REQUESTED. Anyway that’s my two cents.

    • shamelesslyatheist
    • Posted February 5, 2009 at 10:40 am
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    I’ve always thought that altruism is a complete myth. I still think Petrie’s intentions were good, but it does smack of the all-too-common ‘look at me! I’m a Christian doing good!’ Even Jesus smacked that kind of thing down (if he even existed).

    There really was only one professional coarse of action – to not offer. If it was requested by a patient, the only professional coarse of action would be to refer the patient to someone trained in providing spiritual services. She had no business doing what she did. What galls me is that this rag of a newspaper is taking up her ’cause’ because she is a Christian and they seem to think this removes any professional boundaries on conduct.

  2. Intentions aside, to me there is still an element of smugness to the act of announcing one’s faith when the situation doesn’t call for it. But I totally agree about her proper course of action.

    • shamelesslyatheist
    • Posted February 5, 2009 at 10:47 am
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    Well, I have to admit to at least a little smugness about being an atheist. But I find it no more acceptable to flout it than the ‘god-given’ right of Christians to go out and convert us heathens.

  3. Youre right about one thing, its better not to ask to pray for them, just tell them you are going to. That way there’s no pressure on them, and people will see it just as a friendly gesture rather than an attempted conversion lol. Im curious, do you think most atheists were at one time fundamentalist christians? Same coin just being flipped.

    • shamelesslyatheist
    • Posted February 14, 2009 at 8:05 am
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    Ooooh, yeah. That would demonstrate the sensitivity to diversity inherent to Christianity, wouldn’t it?

    An interesting question. This is pure speculation on my part, but the demographics would suggest that by far people become atheists via Christianity. There are just too many families following Christian doctrine relative to nonreligious families to account for growth. It’s not like we’re Catholic and don’t use family planning. So I think the current growth in atheism/agnosticism is definitely due to deprogramming.

    Whether Christians who become atheists are from the more fundie sort, I can’t say. I’ve met atheists from all sorts of backgrounds and it is really a spectrum of paths to atheism. It also depends on the definition of fundie being used. You can move the line however you want since there is no hard and fast line determining fundie from ‘moderate’ (if there is such a thing as a moderate Christian in the first place).

  4. Not all prayer is necessarily Christian nor is it religious in a traditional sense. Also in regards to Atheism/Fundies, I just find it interesting that both are so absolute in their “belief” systems.

  5. Hey Shame

    check out my post on Jan 13, Id be curious what you do. 😉

    TitforTat6.blogspot.com

    • shamelesslyatheist
    • Posted February 16, 2009 at 8:30 pm
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    LOL! No, don’t quite use the religious exclamation.

    Steven Pinker notes that expletives are typically one of three subjects. Two include (I can only remember two of them at the moment): religion and bodily function. It’s cross cultural and regardless of belief system and no one knows why.

    • shamelesslyatheist
    • Posted February 17, 2009 at 9:48 am
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    Oh, and banterbox, what’s with the editorial comment “Also in regards to Atheism/Fundies, I just find it interesting that both are so absolute in their “belief” systems.”? Do you mean our pesky requirement for extraordinary evidence to reject the null hypothesis in favor of an extraordinary claim? How unreasonable of us.

    Really, though, the majority of atheists don’t care what others believe. The rise of more vocal atheism is a reaction to the attempts of religious wingnuts to transform what was intended (and rightly so) to be a secular society into a theocratic one. We stand for equal rights for everyone, even those who would take them away using religion as a justification. One prong of the attack on that type is to call bullshit.


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