From efficacy to safety concerns: a STEP forward or a step back for clinical research and intercessory prayer? The Study of Therapeutic Effects of Intercessory Prayer (STEP).

From t Submi Reprin Fulton E-mail: Am He 0002n 200 doi:10 and religion as irreconcilable antagonists. . . I maintain that cosmic religious feeling is the strongest and noblest incitement to scientific research. . .Q Einstein, A. The World as I See It Systematic study of intangible bnoeticQ or bfrontier Q healing methods such as intercessory prayer, defined as bwidely practiced therapeutics with no plausible mechanism, Q is an area of great public and scientific interest, as well as of great controversy. Although prayer is one of the most ancient of healing practices, the scientific literature studying prayer is still quite young. In this issue of the journal, Benson et al report the sixth and largest prospective, randomized, placebo-controlled study of distant prayer cardiovascular patients in the STEP. It is not surprising that so much of the study of healing effects of prayer would be pursued in the bhigh techQ world of cardiovascular care, as heart disease invariably faces patients, families, and loved ones with the immediate prospect of death, myocardial infarction, and stroke, either from the disease or from the procedures associated with its treatment. In this setting, the cultural practices of patients, families, and medical staff frequently include the personal use of prayer or solicitation of prayer with therapeutic intention from other devotees. Previous trials include 3 studies in coronary care unit populations and 2 in percutaneous coronary intervention populations. STEP is the first report of distant intercessory prayer in patients undergoing coronary artery bypass surgery. In the absence of mechanistic insight, attention to the quality of clinical trials science used for the study of an emotionally and culturally charged btherapy Q such as intercessory prayer becomes critical to the interpret-