Praying for others to cure diseases?
Cochrane review of intercessory prayer is a pillar of shame
Alternative medicine has much in common with religion. It is full of dogma, pseudoscientific and supernatural thinking, and the dogma does not change, no matter how absurd it is or how much scientific evidence is presented disproving it. Homoeopathic dilutions are still the same as those used over 200 years ago, which means patients are treated with nothing but water.1
Science is the antithesis of religious beliefs, which defy logic and facts. One would therefore expect a Cochrane review of randomised trials of intercessory prayer to be amusing, either on purpose, as a type of jest published on April Fools’ Day, or unintentionally. And indeed, the Cochrane review of praying for others to cure diseases2 is beyond belief, so to speak.
The arguments in the Cochrane review are utter nonsense
The Cochrane review goes far beyond what science and reason can justify and uses an unsound mixture of theological and scientific arguments.3,4
From a scientific perspective, the a priori likelihood that prayer could be effective against diseases other people have is extremely small because it involves three assumptions that are all highly unlikely to be true.
First, the existence of a god; second, that prayer can somehow travel in space and reach this god, or that it works through a mechanism unknown to science; third, that this god is responsive to prayer and can influence - from a distance - what would otherwise have happened.
It therefore seems futile to perform randomised trials of the effect of prayer on those prayed for. Any observed effect would more likely be due to the play of chance, bias or fraud than to divine intervention. Down to earth, it would be more fruitful to study possible psychologically soothing effects among those who pray.
The Cochrane authors say that “outcomes of trials of prayer cannot be interpreted as ‘proof/disproof’ of God’s response to those praying,” and that what they attempt to quantify is an “effect of prayer not dependent on divine intervention.”2
It is difficult to understand what they mean by this. Why would people pray to a god if an effect of prayer is not caused by divine intervention, and what is then assumed to be the causal mechanism? The authors provide no explanation, and it is hard to imagine how prayer for sick people located at the other side of the globe,3 and who are unaware that someone prayed for them, could have an effect on disease without assuming divine intervention.
The authors even contradict themselves. They say that their review focuses on people “setting time aside to communicate with God,” but also that the review is not about divine intervention.
It is also hard to accept that a god would help Peter in bed A, because someone, after randomisation, was asked to pray for him, but not the less fortunate Paul in bed B.
They authors say that “If understanding of God is as limited as the Holy Literature suggests (1 Corinthians 13:12), the consequences of divine intervention may be considerably more subtle than could be measured in the crude results of a trial.” If that was a real concern, they should not have undertaken the review, because their reservation means that people who do trials of prayer cannot rely on what they observe.
As I noted in an earlier article,5 arguments like these are often used by practitioners of alternative medicine. They say that the research setup somehow makes it impossible to measure the effect of their treatments. In the theory of science, this approach is called immunisation of the research hypothesis. It means that, regardless of the experimental results obtained, believers will be unaffected and will continue claiming with equal conviction that their treatments are effective.
Another statement also belongs to the realm of mysticism. The authors write that “An omnipotent God would make concealment of allocation (of the participants to prayer or no prayer) impossible and may be noncompliant with the limitations of a randomized trial (Psalm 106:14,15, Job 42:2).” Since such a god could interfere with the experimental setup, it is difficult to understand why the authors excluded trials in which the treatment allocation was not concealed, and why they bothered to discuss the level of concealment in the trials they included.
Important issues with the included trials
There are ten trials in the review aimed at testing the religious belief that praying to a god can alleviate ill health in those being prayed for.2
The Cochrane authors did not discover, or chose to ignore it, that a suspicion of fraud had been raised against a large trial of in vitro fertilisation (see below),6 and that the largest “trial”7 was published in BMJ’s Christmas issue and was meant to amuse, in line with the tradition of this special issue, rather than present scientific evidence.3 This “trial” evaluated the effect of prayer taking place 4-10 years after the patients had either left the hospital alive or had died from their bloodstream infection. Thus, the trial evaluated the effect of retroactive intercessory prayer using historical data and its author argued that we cannot assume “that God is limited by a linear time.”
The Cochrane authors did not mention anywhere that the patients were randomised many years after their outcomes had occurred and did not discuss the likelihood that time can go backwards and that prayer can wake the dead.
The author of the retroactive prayer study subsequently noted that “if the pre-trial probability is infinitesimally low, the results of the trial will not really change it, and the trial should not be performed. This, to my mind, turns the article into a non-study.”8
The non-study “found” a nonsignificant 7% reduction in mortality for those prayed for, but since it carried 75% of the weight in the Cochrane meta-analysis, it led to a statistically significant effect of prayer.
Two years later, funnily enough also in the Christmas issue, people with an interest in alternative medicine, prayer and healing tried to explain why the results of the retroactive study could be true using arguments from quantum theory.8 They seemed to take their arguments seriously, even though they were total nonsense, which a physicist and a doctor demonstrated a year later - again in the Christmas issue.9
It should not be too difficult to realise that prayer cannot make dead patients come to life again. Furthermore, what the randomisation did was to divide both the living and the dead into two groups, which were then compared statistically. This is an abuse of statistical testing because we already knew that any differences between the two groups were random.
The in vitro fertilisation trial6 was also “amusing.” It originally had three authors, but the senior author subsequently withdrew his authorship.6 Requests for clarification addressed to the authors and editors of The Journal of Reproductive Medicine where the study was published were not answered and not a single critical letter was published in the journal.10,11
The trial was carried out at Columbia University in New York City and a news release from the university stated that the senior author – who was no longer an author - led the trial. This was not true. The vice president noted that the senior author first learned of the trial from the first author six to twelve months after it was completed.10
As I noted in an earlier article,1 one of the two remaining authors, lawyer Daniel Wirth, was sent to prison after 20 years of continuous criminal, fraudulent activities,10,11 and the other author provided incorrect and misleading statements about the research12,13 after being challenged by the editor to provide explanations when the scandal broke loose three years after the trial was published.
Wirth organised the study which reported a significantly higher pregnancy rate in the prayer group (50% vs 26%, P = 0.001) after in-vitro fertilisation at a Korean hospital.6 The prayer was carried out in USA, Canada and Australia and those who prayed were Christians, as opposed to the Korean patients. Another curiosity is that the Catholic Church condemns in-vitro fertilisation. It would therefore have been equally reasonable to conclude that the responsive god was not very well represented by the Pope as to conclude that one should pray for those seeking in-vitro fertilisation.
The Cochrane authors made fools of themselves in other ways. A large study (1802 patients) of coronary artery bypass graft surgery found that complications occurred in 52% vs 51% whereas there were more complications when patients were told they would be prayed for, 59% vs 52%.14 Instead of discussing the plausibility of this finding, the authors concluded that praying people should be “cautious about informing the recipient” when it comes to surgery, and that managers and policymakers may wish to exercise some caution about “praying at the bedside of those who are about to have a surgical operation.”
The amusement wasn’t even over. The Cochrane authors argued that the lack of effect on complications might be because the participants only received prayer for 14 days!
The authors’ inclination to theological reasoning also led to a tautology: “A caring God may not wish to prolong suffering, so death therefore might be a positive outcome of prayer.” This is a perfect immunisation of the hypothesis that makes trials of prayer meaningless. If people survive, it is good for them, and if they die, it is also good for them.
Moreover, the authors’ reasoning assumes the existence of an omnipotent, caring, and all-knowing god. But what if that were true? Why should we then try to influence our fate by praying when such a god already knows what is best for us?
The review was published by the Cochrane Schizophrenia Group, which makes sense, as it is full of delusional thinking. We informed the editor, psychiatrist Clive Adams, about the major problems and published a comment alongside the review. To our big surprise, he assured us that the review wasn’t a joke.
After our criticism, the review was updated and the authors changed their conclusion.15 Originally, they wrote that “The evidence presented so far is interesting enough to justify further study into the human aspects of the effects of prayer.” In the update, they wrote: “We are not convinced that further trials of this intervention should be undertaken and would prefer to see any resources available for such a trial used to investigate other questions in health care.”
Was this little glimpse of reason an order from above – from a god – or had the Cochrane leadership asked the authors to be more reasonable? If from the Cochrane leaders, they should have required more. The authors still included the study of retroactive prayer, with the most mysterious arguments: a “relevant study,” “not in jest,” but “a rather serious paper.” They also said that “retrospective prayer is practised by some people,” and that the study was double blind since those praying did not know the outcome for any of the patients.
This is Cochrane at its worst. As the outcome was already known for all the patients, it is wrong to give the study bonus points for being “double blind.” The Cochrane authors perverted a sound methodological principle without even being aware that they made themselves laughable.
About the possibility of waking the dead through prayer, they said: “Retrospective prayer may be considered theologically controversial, but we are not concerned with theology. Our aim is to review the empirical evidence for the efficacy of prayer as a treatment for ill-health rather than to consider questions of metaphysics. We judge ourselves bound to analyse the results of any trial that fits our original criteria (including our initial definition of prayer) and which is methodologically well constructed. Having set our protocol we are convinced that it would be unscientific to modify it to exclude a study that fits our criteria for inclusion.”
This dogmatic cook-book “science” is the very bottom of Cochrane nonsense. A comedian could not have invented this; it is just too surreal. Whether researchers have a protocol or not, they are obliged to think. Otherwise, it is not science. And review authors are free to not include unreliable studies in their meta-analyses.
Praying is practised by billions of people. Almost half of all Americans pray daily.16 Religious people should realise that no one is listening to their prayers,17 apart from themselves and people nearby who can hear what they are saying.
Cochrane has refused to retract the review
It is a scandal for the Cochrane Collaboration that this nonsense review has not been retracted.
In 2008, I asked Lorne Becker, chair of the Cochrane Steering Group’s Publishing Policy Group, to withdraw the review. He responded that it was not part of the group’s remit to remove reviews that some people might find embarrassing and he argued that if they did, there would be other such reviews, and that the editorial decision should be taken by the Cochrane group that approved the review.
I replied that the Steering Group had been involved with other cases of retraction and that the editors who had approved the review had a conflict of interest. They might not want to retract a review they had themselves approved and published, even when the errors were very grave.
Becker noted that the review had been discussed at a Centre Directors meeting (which I had called for), and that the group had not requested any action. “In fact, Prathap Tharyan [an editor in the Cochrane Schizophrenia Group] told of how this particular review has been very helpful to him in promoting the Collaboration with his colleagues in India.”
Finally, Becker told me that he did not find “the review embarrassing in the least,” but that it would be embarrassing for the Cochrane Collaboration if they withdrew it.
This was 18 years ago but Cochrane has deteriorated substantially, morally and scientifically, since then. No one should be surprised that Cochrane is now a moribund organisation.18,19
References
1 Gøtzsche PC. None of the most popular alternative remedies are effective. And it can be deadly to believe that they work. Substack 2026;Feb 22.
2 Roberts L, Ahmed I, Hall S. Intercessory prayer for the alleviation of ill health. Cochrane Database Syst Rev 2007;1:CD000368.
3 Jørgensen KJ, Hróbjartsson A, Gøtzsche PC. Divine intervention? A Cochrane review on intercessory prayer gone beyond science and reason. J Negat Results Biomed 2009;8:7.
4 Gøtzsche PC. Cochrane review of intercessory prayer: a pillar of shame for Cochrane. Institute for Scientific Freedom 2024;Oct 14.
5 Gøtzsche PC. Alternative medicine is no alternative. It doesn’t work and may kill people. Substack 2026;Feb 6.
6 Cha KY, Wirth DP, Lobo RA. Does prayer influence the success of in vitro fertilization-embryo transfer? Report of a masked, randomized trial. J Reprod Med 2001;46:781-7.
7 Leibovici L. Effects of remote, retroactive intercessory prayer on outcomes in patients with bloodstream infection: randomised controlled trial. BMJ 2001;323:1450-1.
8 Olshansky B, Dossey L. Retroactive prayer: a preposterous hypothesis? BMJ 2003;327:1465-8.
9 Bishop JP, Stenger VJ. Retroactive prayer: lots of history, not much mystery, and no science. BMJ 2004;329:1444-6.
10 James Randi Educational Foundation. The Columbia University scandal. 2004.
11 Flamm B. The Columbia University ‘miracle’ study: flawed and fraud. Skeptical Inquirer 2004;28(5).
12 Cha KY. Clarification: influence of prayer on IVF-ET. J Reprod Med 2004;49:944-5.
13 Flamm BL. Prayer and the success of IVF. J Reprod Med 2005;50:71.
14 Benson H, Dusek JA, Sherwood JB, et al. Study of the therapeutic effects of intercessory prayer (STEP) in cardiac bypass patients: A multicenter randomised trial of uncertainty and certainty of receiving intercessory prayer. Am Heart J 2006;151:934‐42.
15 Roberts L, Ahmed I, Hall S, Davison A. Intercessory prayer for the alleviation of ill health. Cochrane Database Syst Rev 2009;2:CD000368.
16 Smith GA, Cooperman A, Alper BA, et al. 10. Prayer and other religious practices. Pew Research Center 2025;Feb 26.
17 Dawkins R. The god delusion. London: Bantam Press; 2006.
18 Gøtzsche PC. Can Cochrane’s new CEO save the sinking ship? Her decisions so far suggest she will go down with the ship. Substack 2026;Feb 1.
19 Gøtzsche PC. Requiem for the Cochrane Collaboration
Please, Mr. Goetzsche: don’t ride on this wave of scientistic hybris! How can you exclude actual ontological facts - spiritual healings, that are documented all over the whole world - just by the application of narrow-minded scientific approach towards these phenomena? The observation that certain events cannot be grasped by measuring methods does not give science the „right“ to exclude parts of reality, which just don’t fit into scientific framework. I recommend to you reading Rupert Sheldrake‘s „The science delusion“ in order to examine your own basic assumptions about what reality is through a broader perspective. I wish that you might return to your critical thinking skills which have helped us during Covid pandemic to unmask the wrong narrative.
Should we pray for Cochrane?