The Science used for the Prayer Experiments
The Great Prayer Experiment is one of many studies made on prayer and one that I think was done poorly. The results were poor to negative so no doubt Dawkins saw reason to choose it for discussion instead of discussing prayer citing the whole range that have been done over the years. Prayer experiments show very mixed results. Some are positive while others are neutral and still others show a detrimental effect from prayer. I will discuss prayer experiment in general and point out reasons why I believe some do poorly and others well. Then I will discuss ethics because there are examples in the prayer experiments that show how ethics can, in part, be studies in biomedical science, given a different medical paradigm.
Dawkins says that such experiments to be done properly must use a double blind as a “standard”. And as I am talking to lay people and not scientists I will explain this first and furthermore to help people understand that the double blinded trial is seriously flawed with respect to many medical experiment, especially in testing drugs and certainly for prayer. Let’s first look at an experiment that probably everyone has done in their life at the ages of 4 or 5 years old or maybe a bit older. A child sees a hot plate on the stove top and while it is not being used goes up to it and thinks what’s that? They touch the hot plate and it feels a bit cold and smooth. Nothing happens. Sometime later when the stove top has been turned on they may again become interested but this time when they go to touch it “ouch!” It feels very hot and burns their fingers. So the child then reasons that it is best not to touch the hot plate because sometimes it’s hot and “hurts my fingers!” Touching the plate while it is switched off and cold can be thought of as the control experiment, or what is often called “the blank”. Touching the plate when it is on is the actual experiment. A comparison is made between the two conditions and as the child has done reasoning follows the result of the experiment.
In the experiment that the child does with a stove we have a human experimenter and an inanimate object, which in the macro world at least, behaves in a reliable, predictable manner. If it is switched off the hot plate stays cold and if it is switched on it becomes hot. When we come to medical experiments we are dealing with human being (or animals) and human beings especially have “a mind of their own” so to speak. They will make decisions for themselves, they will uphold ideas about what is happening, which often affect their body functions and they will reason in their own way depending on their circumstances. All of this makes them unpredictable and unreliable as subjects of an experiment. One of the big problems is with what is known as the placebo effect. This was seen in randomized single blinded drug trials with respect to the drugs and not with those who had the blank or dummy drugs. The problem was that people were able to insightfully perceive what the research doctor knew, ie whether they had a drug or a blank. At least some of those that discovered they had a drug had an expectation of getting well which helped them get well. This is called a placebo effect. It was bad news for the doctors because it meant that the efficacy of the drugs could not be properly tested because they did not know how much their recovery was due to the drug and how much was due to the placebo effect. Thus they devised the randomized double blind drug trial.
With a randomized double blind study the researchers hoped to eliminate the placebo effect. So both the doctors and the participants are kept in the dark as to who gets the trial drug or surgery and who doesn’t. The real aim is to stop patients from gaining insightful information if the doctors know who gets what. However doctors do not want to accept ESP and insightfulness, after all they believe and treat the human being and animals as machines, so they cite two different reasons. One reason they say is to stop doctors from “unintentionally tipping off the participants”, which they then claim means the patients are influenced by the ‘power of suggestion’. The second reason they give is to stop the doctors from unconsciously biasing their evaluation of results, so someone uninvolved analyses the results. Both reasons are important but the first reason is the critical one because when a patient knows what they are getting a placebo effect is unavoidable.
To explain the placebo effect we can look to a doctor giving a patient pills, which contain a harmless substance with no definite pharmacological effects against the patient’s illness, in clinical practice. The pills only contain something like weak salt solution, distilled water, or sugar. They call this “fake medicine” and a placebo. This is not really fake medicine. They are calling it fake because there is no pharmaceutical product in the pills and doctors really only recognize the pharmaceutical as a valid ingredient to call the drug ‘real medicine’. They do not recognize an idea as an ingredient so as to call the dummy drug real medicine. The doctor however tells the patient that the medicine he or she is given them contains an powerful drug, so the patient thinks they are getting “real medicine”. A lot of doctors think this is being dishonest because they are not telling the patient the truth. Other doctors use this approach because they see that they are making a suggestion with the medicine given that will help the patient expect to get well. The suggestion is the all important ingredient that makes the inert substance a placebo. However it is not the suggestion of itself that has potency. The suggestion causes the patient to uphold a critical idea with confidence in mind. That idea is that they can expect to get well. In research however this is not the case. And yet doctors still want to call any inactive substance used as a control in an experiment as a placebo. It is not a placebo. It is a blank or inert substance and the patients know that. The patients who participate in a drug trial know that some will get a drug and some will get a dummy drug or blank but they don’t know who gets what. By calling the dummy drug a placebo they are deliberately skewing their results because they are telling the patients that they will get something that makes some people well. The dummy drug should not be given with any suggestion so it is wrong to call it a placebo. Doctors call the inert drug a placebo because in a double blinded trial they see that some of the patients taking the dummy drug get well. However they deny the truth of the matter. In single blinded experiments the placebo effect was not seen only with the real drug and NOT with the blank or dummy drug. People taking the blank did not get well.
It is also important to say something about doctor’s belief that a placebo effect comes about owing to the power of suggestion. The word placebo is derived from a Latin word meaning “I shall be pleasing” The problem of the placebo is not merely a matter of suggestion and I doubt that the patient aims to please the doctor either. Firstly a suggestion has no power to bring about any effects and secondly the patient is not interested in pleasing the doctor but in getting well for their own sake. You can make all manner of suggestion to someone but if that person doesn’t accept the suggestion and make it a belief because it has significance for them then there is no effect. The doctor makes a suggestion in giving a patient in a clinical setting a dummy drug but only when the patient accepts the suggestion is there a placebo effect and they know this. There is plenty of evidence that points to something other than mere suggestion and a supposed patient’s desire to please being involved. In a clinical practice a doctors may find that some of his or her patients may become “addicted” to the dummy drug that they have been given. This means that the person has developed dependence to what? Distilled water or a weak saline or sugar solution! Clearly the pills are not addictive, especially if we consider the medical reasoning surrounding addiction. The patient is really a person who is suffering from stress and when they have taken the pills which they believe is strong medicine, the idea of getting well has helped them overcome the stress. However when the stress is due to toxic relationships and other people in their lives wanting to manipulate them or hurt them then such stress is ongoing. The patient believes that the pills helped but the pills did not help them directly. The pills were only an anchor for an idea. It was their own belief that helped them. Not realizing that their idea is all they need to stay well, they go back to the doctor wanting more pills to stay well. It is the belief of the patient that counts but that belief is anchored on the pills the doctor gave them. The suggestion was only that the pill would make them well and not that they need ongoing supply of the pill to stay well. That same suggestion that is made in clinical practice should not be made in a drug trial. Calling the blank as a placebo will encourage some patients to believe they will be given something that makes some people well. It further skews results that are already affected by placebo.
Other patients may even present with side effects and a few even get worse on the dummy drugs. Doctors call this a nocebo effect. Here too it is not the suggestion of the doctor, even though the patient may see the doctor as the authority. It is only when the suggestion is accepted and upheld in mind with confidence that it becomes potent and this time detrimental. The side effects and getting worse on the dummy drug or fake medicine have to do with further suggestions. They may be from insightful information about what ideas the doctor entertains and does not voice to the patient or it may be from other people in the person’s life either verbalizing or thinking that “there may be harmful effects from what they are taking” or it might had to do with the patient’s fear of medicines and drugs. Which ever it is, it is still the patient’s belief, and not the suggestions, that counts.
So are these experiments even scientific, let alone standards?
What doctors don’t want to admit to is that in a double blinded experiment all patients in the trial, both those with the drug and those with the dummy drug, are affected by placebo effect. Why is this so? We need to appreciate that the patients, who take part in drug trials, are most often desperately sick people. For many the drug trial is seen as their ticket to health where all else has failed or where there is no other drugs available for their ailment. Such a person will say to themselves “I don’t know what I’ve got but I’ve got a fifty-fifty chance that I have been given a drug. The odds are even! Yeah I believe I am one of the patients given the drug. Yeah I got a drug! I’m sure of it. I’m gonna get well!” This sort of reasoning is autosuggestion and it leads the patient to uphold what they see as an attractive idea with confidence in mind, i.e., they uphold the idea that “they can expect to get well” as a belief. This is a self-administered placebo. Indeed when we consider the matter closely we find that all placebos are self-administered because the patient needs to take the suggestion to heart and uphold it with confidence in mind to experience the placebo effect. This makes the trials worse not better because where they had one problem before they now have two problems.
1. They have no idea how many taking the drug being tested are showing a placebo effect just as they did in a single blinded trial or indeed a nocebo effect and
2. the dummy drug, which is used as a comparison, is now unreliable. Patients are now getting well with the dummy as well as with the drug, which they didn’t do in a single-blinded trial! And the researchers that call the dummy drug a placebo significantly add to this problem because that is as good as suggesting to at least some of the patients that they may get well on what they are given.
They are looking to say that the drug is “significantly better” than the dummy or what they are calling placebo. To get this “significantly better” business they do hundreds of experiments in some cases until they get the one or two in which more people with the drug got well than those with the placebo. And they discard the hundreds that they did in favour of that one or two and use those to put under the nose of the “blinded statistician”. It explains why they need the statistician blinded, otherwise how could he or she get the desired results? It is hocus-pocus. The experiments are anything but scientific. What they won’t admit is that experiments in the biomedical sciences are very imprecise, to state the matter kindly. To be brutally honest their experiments are bullshit. The drugs are used in practice to make people well and they sue people who say the drugs don’t work. The question is why do the drugs work? Do the drugs do anything or is it all due to the placebo effect? Randomized double or single or triple blinded trials as scientific experiments are imprecise at best and they are imprecise because they are dealing with human subjects. And if the truth be known even the laboratory animal studies are fraught with problems because medical scientists have no respect and no regard for life. They treat laboratory animals abominably. How can you get results if the animal’s bodies are reacting with fear and hostility or if the animals are kept restricted in spaces in which they cannot move for days and months at a time? The biology is skewed. Cruelty to laboratory animals is all that their experiments are about.
Scientists claims that humans having no free will, that their faith is a delusion and either your genes or your brain is in the driver’s seat, depending on whether you’re talking to a evolutionary biologist or a neuroscientist. Despite these claims humans do have free will and faith and can, unlike automatons make unique, deliberate and free choices and uphold beliefs that are potent enough to make them well, even from the worst diseases. All of these qualities do not make them good science subjects that behave in a predictable or consistent manner. Medical scientists have a hide to point to what they call “primitive systems” like Traditional Chinese Medicine and say the herb are not tested scientifically and thus “no good” or in a condescending fashion claim the herbs are “not as good” as their drugs. Firstly TCM, through trial and error observation methods have been tested on hundreds of millions of subjects over a five thousand year history or longer and they have been not simply been adjusted to treat particular ailments, they have been fine tune in their uses with other herbs in TCM prescriptions. Secondly it is true TCM herbs and other treatments like acupuncture haven’t passed the scrutiny of scientific testing, but if they were honest about it, neither have modern Western drugs and many types of other treatments including surgery! For example an orthopaedic surgeon in the States found in experiments with knee surgery, that the dummy surgery (punctured two holes near the knee and sticked them up) proved to be just as good as the real operation, with lasting results. The reason is the person’s belief made them well. A placebo effect here too! The use of a double blind that Dawkins points out and insists should be used, is hardly a standard. Instead of making the experiments “more scientific”, double blinding skews the results far more than the single blinding had done. What Dawkins doesn’t like is faith because faith, and worse still God, is the evidence that Darwin worried about, that once shown to be real, would destroy his theory of evolution.