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The other day I wrote a blog on the nurse who was suspended without pay last December for asking an elderly patient (who apparently did not solicit the invitation) . Caroline Petrie is now free to go back to work as a bank nurse (a nurse who is called in as needed on an hourly basis). There was a great deal of public pressure brought to bear on the hospital for the suspension, mainly out of a misunderstanding about what was going on. Some bloggers feel that this is a Christian being thrown to the lions, a martyr in the making.

Baloney. This was never about Petrie, but rather it was about patient care and upholding ethical standards. Simply put, Petrie violated a code of conduct to which she is professionally obligated to follow. If she has a problem with not abiding by a pretty standard section of medical ethics, she’s free to choose another career path.

It’s a bit easier to see the problem when the context is changed a bit, particularly for those who share Petrie’s religion of choice. For instance, if she had been a practitioner of voodoo and offered to sacrifice a chicken to Baron Samedi, I’m sure a very different brouhaha would have resulted. As Richard Sloan points out in his book Blind Faith: The unholy alliance of religion and medicine, there are just some boundaries a health care worker should not cross (and presents a few scary real-world examples of such outrageously unethical behavior by health care workers – I highly recommend the book).

Professionals are available to deal with a patient’s spiritual needs and if – and only if! – the patient requests such services, she could refer the patient to one of them. This is the professional way to handle such things. But Petrie (and many people who have no knowledge of medical ethics) think that acting in such an unprofessional manner is okay. Being Christian is not an excuse to violate codes of ethics.

At first I thought that maybe the hospital was being heavy handed, but then wondered if she had a history of such activity. Indeed, she does –

Mrs Petrie revealed she had been reprimanded over her faith before, when in October last year she gave a homemade prayer card to an elderly patient.

If this had been her first offense, I would have some compassion for this woman. But knowing that this isn’t her first foray into such activity, my sympathy for her situation is greatly diminished. She offered the prayer in the full knowledge that she was violating her profession’s code of conduct. If she wishes to deal with a patient’s spiritual needs she should obtain the requisite training. And, as my brother pointed out in the comments in the previous chapter of this saga, why didn’t Petrie just go and pray for the patient? Why make a show of it by making the request?

Mrs Petrie previously argued that she had not forced her beliefs on anyone and simply asked if the woman at the centre of the controversy would like a prayer said for her, as she has done with other patients.

Religion should be private. The very act of asking by a health care worker, however well-intentioned it may be, is unethical simply because of the power a nurse holds over the patient.  

This may seem harmless, but it isn’t. It opens the door to all sorts of actions which have nothing to do with offering a standard of care and may well negatively impact patient care. Standards of care are carefully-considered evidence-based treatment regimens, and prayer is in none of these. For good reason, too – it has no discernible effect, as I discussed yesterday. 

But Petrie thinks she knows better and accepts anecdotal evidence without bothering to obtain rigorously-obtained empirical (i.e., real) evidence – she claims to have seen the power of prayer in healing:

The Baptist, who became a Christian 10 years ago after her mother died, said her prayers had real effects on patients, including a Catholic woman whose urine infection cleared up days after she said a prayer.

Guess the clearing up of the infection had nothing to do with the antibiotics that were given after all. C’mon! Use of anecdotes as evidence is bad Science. Might as well stand over the patient and chant. If the patient gets better, hey! Chanting works! Talk about spurious logic!

I mentioned in the previous segue that prayer has been studied rigorously and the best studies (like the STEP and MANTRA studies) show no effect. One British tabloid, The Sun, cites a paper from the Journal of Reproductive Medicine1, a fairly respectable publication:

A study in the US Journal of Reproductive Medicine found that prayer doubles the success rate of IVF.

When volunteers were asked to pray for certain couples having fertility treatment, the women who were mentioned in the prayers had a 50 per cent pregnancy rate – twice the level of success compared to those who were not mentioned.

I knew immediately which studied they were talking about. This obvious rag of a newspaper didn’t bother to mention the controversy surrounding and permeating this study. The controversy is not in the conclusion that prayer had an effect. The controversy is centered around the deep experimental design flaws and outright fraud.

One of the authors (Wirth who, curiously, has no science, medical background or affiliation with any research institution, but is a lawyer with a ‘degree’ in parapsychology(!)…) plead guilty in 2004  to the charge conspiracy to commit mail and bank fraud. Lobo (who withdrew his name from the author list) claims to have not been involved with the study until after its completion and to have provided only “editorial assistance.” Lobo, at the time chairman of the Obstetrics and Gynecology Department at Columbia University in New York, pretty much ended his career associating himself with such sleazy and slipshod work. The irregularities are positively glaring and a number of researchers have questioned whether the study was ever actually performed at all!2

To be fair, The Sun gives copious time to the studies which fail to show any efficacy of intercessory prayer:

But a recent large trial failed to show any benefits for patients undergoing heart surgery.

Did you blink while reading that? Then you missed the whole ‘copious’ amount. One measly freaking sentence, a vague reference to (maybe) one of either the STEP, MANTRA or MANTRA II studies. There’s no bias here towards bullshit at all, is there?

The so-called “Columbia Miracle Paper” has since been retracted by the journal. Talk about irresponsible journalism and irresponsible Science!

Reference

  1. Cha KY, Wirth DP and Lobo RA. Does Prayer Influence the Success of In Vitro Fertilization-Embryo Transfer?  Journal of Reproductive Medicine 46:781-7 (2001)
  2. Flamm BL. Prayer and the success of IVF. Journal of Reproductive Medicine 50:71 (2005)
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