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August 19, 2005

The ethical dilemma of faith healing

Those people who read the Plain Dealer would be aware of the sudden rise to fame as a faith healer of Dr. Issam Nemeh, a general practitioner (and Catholic) in the Cleveland area who also practices faith healing, in the form of using heated acupuncture-type needles, the passing of hands, and prayer.

The Plain Dealer has given him considerable coverage in the past, leading up to well-attended faith healing services held earlier this year in a Catholic Church and at the HealthSpace Cleveland Museum. He is now said to be the area's most sought after physician, booked through 2006, and patients often wait until midnight to get to see him, paying $250 for appointments.

But not everyone is happy and a recent article reports on those who feel they have been had. They say that he made claims about their cures that were not substantiated, and that his assistants seemed to be overly concerned with getting their money and made outlandish claims that angels visited him regularly.

Is Nemeh a fraud? It is tempting for those of us who are not religious to think so, since we do not believe that supernatural forces exist. After all, a recent study in the medical journal The Lancet (free registration required) finds that prayer and touch have no effect and Bob Harris argues on other grounds why such claims are unlikely to be true.

This is not the first time that claims that prayer leads to successful healing have been found to be wanting. The December 3, 2004 issue of the newsletter What's New said:

PRAYER STUDY: COLUMBIA PROFESSOR REMOVES HIS NAME FROM PAPER. We have been tracking the sordid story of the Columbia prayer study for three years (WN 05 Oct 01). It claimed that women for whom total strangers prayed were twice as likely to become pregnant from in-vitro fertilization as others; it was published in the Journal of Reproductive Medicine. At the time we were unaware of the background of the study, but knew it had to be wrong; the first assumption of science is that events result from natural causes. The lead author, Rugerio Lobo, who at the time was Chair of Obstetrics, now says he had no role in the study. The author who set up the study is doing five years for fraud in a separate case, and his partner hanged himself in jail. Another author left Columbia and isn't talking. The Journal has never acknowledged any responsibility, and after withdrawing the paper for "scrutiny," has put it back on the web. Nor has the Journal published letters critical of the study. Columbia has never acknowledged any responsibility. All of this has come out due to the persistence of Bruce Flamm, MD. The science community should flatly refuse all proposals or papers that invoke any supernatural explanation for physical phenomena.

While it is natural for religious believers to think there could be some healing effect of prayer, it is possible for non-believers in a supernatural power to accept it too. Even if there is no god, the mind-body connection makes it possible that a person's will and attitude can influence the biochemical processes in the brain and body and produce actual physical effects. As the Plain Dealer article on Nemeh states "Even skeptics agree that faith and prayer can improve one's mental state, which can in turn promote physical health. Some also suggest that people who report being cured by faith healers are probably experiencing a placebo effect, a powerful phenomenon in which symptoms improve on the mere belief that a remedy is at hand."

And it is this possibility that causes the ethical problem. Here is a hypothetical situation. Suppose that a small number of people (say about 1% of those who are sick) respond favorably to "faith healing" this way via the mind-body connection or placebo effect. The catch is that we do not know a priori which ones will do so. Since it seems essential that people have faith in order for this method to work on them, everyone has to maintain the illusion that god is acting through prayer.

So here is the dilemma. If someone believed that there was no god but still wanted to help people, is it unethical for them to pretend to be a faith healer and treat people? After all, even if just 1% get better and nothing bad happens to the rest, isn't that still a positive result? I am assuming that everyone is acting on the best of motives and that the "faith healers" are not con artists preying on desperate and gullible people and swindling them out of their money. Let us assume they are pretending to be faith healers for purely altruistic reasons.

And as for the rest of us who have no ambitions to be faith healers but are simply skeptical observers, should we go all out to debunk faith healers in the name of truth and because we feel it is bogus or should we just stay out of the whole thing because of the benefits it might be having on a few people? If you were the faith healer's friend and knew that he/she was faking belief, would you feel obliged to expose him/her in the cause of truth?

One negative that immediately comes to mind is that people who believe in faith healers might neglect taking conventional treatments that might help them. Another is that the disillusionment that comes with failed faith healing efforts might make these people despair and think that god either does not care for them or wants them to die, creating a negative mindset that surely cannot be helpful.

I think this question illustrates the dilemmas that often occur when abstract principles of truth and honesty come into collision with the needs of real people in desperate need.

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Comments

I would add to your list of downsides that people are paying, in this case, $250 an appointment for medical treatment that isn't medical.

Quite apart from my opinion that "faith healers" are charlatans who prey on the credulous, when I want spiritual assistance I go to the clergy. When I go to a doctor, I want medical help, not laying on of hands.

Posted by Mark on August 19, 2005 01:21 PM

Isaac Asimov once said "If knowledge can create problems, it is not through ignorance that we can solve them."

I believe that very strongly, and feel it applies here as well.

(Though I was immediately disappointed when I read Foundation, as it unapologetically embraced the exact opposite for the very premise of the story.)

Posted by Tom Trelvik on August 19, 2005 03:54 PM

Disclaimer: I have not fully researched several of the subjects I am about to discuss, so if I say something totally false, feel free to correct me. Mostly these are just my thoughts.

Faith healing is indeed a very sticky subject. However, I think there is an aspect of it that Western medicine has a tendancy to ignore - the concept of a comprehensive approach to medicine. By this I mean the concept that not only are the mind and body not separate, but each can influence the other in very significant ways.

I read an interesting article on bbc.co.uk: http://news.bbc.co.uk/2/hi/health/2616771.stm

In Western medicine, the placebo effect is considered to be an unwanted side effect of a "dummy" drug or treatment that shows up in double-blind studies, but is then ignored when the actual medication or treatment is prescribed.

Yet, the placebo effect can be very powerful, and I believe it should be harnessed. Lower doses of medication, or even the absence of medication (and therefore of its side effects) would be extremely valuable in the long-term effectiveness of many treatment systems. An example of the power of the placebo effect: http://news.bbc.co.uk/2/hi/health/4508597.stm


Faith healing can have the placebo effect, as you mentioned. Since there is no good method of "certifying" such "doctors", anyone with a bit of good luck to effect successful "treatments" or "cures" would also have the freedom to name him/herself a faith healer and begin to take customers... er, I mean, patients.

Perhaps a good way of measuring whether someone is truly a faith healer, one should require that person to provide treatment free of charge, or submit their budget to a review board made up not of other faith healers. Short of ensuring that the money they are taking in is not going towards a new yacht or something like that, there isn't much we as a society can do to restrict faith healers. Yes, their patients may end up taking the "healing" instead of their cancer drugs, but ultimately, isn't that up to the patient? If I believe that in vitro fertilization is wrong because there are so many other children out there who need parents that it is selfish of me to spend thousands just to have one that has my genetic identity, that's fine, and society can accept that. However, the reaction would be quite different if I wanted to outlaw in vitro. I may think it is wrong for very good, very compelling reasons, but ultimately, doesn't the decision lie with the couple who want to be parents?

One of my coworkers yesterday made a comment: "Don't we have laws to protect us from our own stupidity?" It really bothered me. No, our laws should not be in place to protect us from ourselves. A law against stealing does not protect me from myself. It protects my property from being taken by another. Our laws should be in place to protect my neighbors from my own stupidity, not from themselves.

So should we be going out there an trying to protect Dr. Nemeh's patients from their choice of faith healing in addition to or in place of more traditionally Western medicine? I don't believe so, no. Provide them with more information, pull his supposed credentials out into public, demonstrate whether what he's doing is actually helpful or not, yes. But arrest him, restrict his ability to practice, forcibly keep his patients from him? No. Unless he has done something that clearly places the public in danger from something other than their own choices, I don't know how one could justify an arrest or something similar.

Posted by Liz V on August 20, 2005 01:24 PM

Liz, I agree with you that the point of laws should not be to protect people from their own ignorance. It sounds like you're okay with going out and proving to people that faith healers are quacks. I think Mano's point is that that is a more morally complicated decision than it might seem on the surface, because it's possible that public debunking of the treatment will prevent the placebo effect from working, thereby ruining the only shot at recovery that some credulous folk have.

I agree with Mano that this is messy and it's a variant of something I've wondered for a long time: is it better to willfully believe something untrue if your belief has a shot at changing the fact of the matter? A mundane example is the observation that placing your trust in untrustworthy people may make them more trustworthy than they would otherwise have been. How intellectually dishonest, then, is it to choose belief?

Posted by Erin on August 21, 2005 10:34 AM

I think Liz makes a valid point, but I don't think this is about protecting Nemeh's patients from themselves, it's about protecting them from him. I think, if any accusations were to be made against him, fraud would certainly be one of them, which is of course a prosecutable offense. If he's making money through fraudulent acts, then that *is* theft. And to commit fraud like this in the medical profession, of all places, seems to me especially reprehensible, regardless of whatever placebo effect some of his patients may be getting out of it.

Posted by Tom Trelvik on August 22, 2005 03:22 PM

Tom, here's a question: would you still consider this prosecutable if the faith healer in question believed his own BS? Because if his belief changes matters, then that takes the teeth out of your will to prosecute; and if it doesn't, then by similar logic you ought to put similar resources into targetting mental health professionals, many of whom go by "feel" or "instinct" in treating their patients rather than by scientific evidence. (Just ask the APA, which (last I checked) refuses to take a clear stand affirming scientific research as the bedrock of clinical psychology, and instead relegates scientific inquiry to a subdiscipline within psychology.) And I'm sure that modern medicine has its share of this as well, given the unlimited power of physicians to prescribe drugs for "off-label" uses. I'm not trying to argue that Nemeh is innocuous or that his methods are no worse than "ours" - I merely want to point out that the *strength* of your faith in the medical profession is perhaps misplaced.

Posted by Erin on August 22, 2005 05:16 PM

Very true, Erin. I can't really say I'm comfortable with the idea of prosecuting when the faith healer truly believes what they're doing works. That would be too close to censorship and "thought police" for my comfort. We can't tell people what to believe, and if both the healer and his patients believe in it, then it should certainly be within their rights to practice it, even if they do so as a paid service.

I still think little mercy should be shown to someone who takes people's money for this without actually believing it works, but that puts an incredibly high burden of proof on the prosecution. As you point out, it takes the teeth out of it.

Posted by Tom Trelvik on August 23, 2005 10:01 AM

Erin and Tom,
You bring up an interesting distinction between law and ethics. In most cases the law does consider the mens rea (The state of mind of the defendant that the prosecution must prove in order to establish criminal responsibility) as well as the supposition that a criminal act has occurred.

In the case of a Faith Healer who believes he is actually healing, it may be that his acts or promises are fraudulent or misleading but not his intent.

Tests of one's state of mind and intent may vary according to the statute in question or the jurisdiction. Perhaps the test is not so much what the healer believes but what a reasonable person would believe in such circumstances. It would be interesting to see if Ohio statutes and/or regulations cover this issue. But I would guess (as a non-attorney) that if he acted in good faith under a test of reasonableness that they wouldn't prosecute, and your side of fairness would be preserved.

Posted by cool on August 23, 2005 06:18 PM

Wake up people. ALL so called 'faith healers' are frauds! Those who don't believe this are so utterly deluded and brainwashed. They are in the same league as those that can supposedly 'contact the dead'. It is no coincidence that the 'psychic' John Edward had a short lived stay on network TV. Hopefully, Nemeh will fade away soon as well.

www.churchofreality.org

Posted by George on December 16, 2005 12:03 PM

"The online encyclopedia Wikipedia has deided to delete articles about the Church of Reality from it's database."

The above is a quote from the church of reality's web site. It looks as if you might fade before Dr. Nemeh.

Posted by phoebe on January 28, 2006 08:17 AM

I do agree with the comment above about faith healer being frauds, however I also believe in the power of the mind. Commenting on why none believer agree with the power of praying: Isn't praying nothing more than meditation? When I was a kid and believed in God, I prayed everyday. Now, I get the same results by meditating, or by doing some Yoga. For people that do not believe this works, check this link out: http://cw11.empowereddoctor.com/story_1182.html
I hope this helps.

Posted by Citronex on June 27, 2007 01:02 PM

When the need is great because there are so many who need help, there are always those who take advantage, the sadness being that they give a bad name to the concept of Healing the Body through means of faith. One of the 10 things that makes us cringe most is watching faith healing television, the outpouring of spiritual gobbletygook, and the healer "zapping" the sick person, who then pretends to collapse, knowing she has to play the game. There are methods of healing in different ways, but one must seek them, then use great caution.
http://www.cathetel.com The Angel of the Garden - Healing the Body

Posted by A Key on November 21, 2007 10:23 AM

The key word is 'faith'. Be wary when money is requested. The original faith healers healed, and were not paid.

Posted by Humble on March 14, 2008 10:46 PM

prayers in the thunder

prayers in the gloom

prayers in darkness

praying with the moon

a thousand whispered prayers rising up on angels wings and communing with the hosts in heaven

and then the prayers are enough

blessings come down like rain.


fierce prayers in the heat of battle

desperate prayers in the heat of the night

wounded prayers lest my soul takes flight

recovered prayers and renewed strength for the fight.

on bended knee, praying with all your might.


life is short: pray hard.


Posted by kudzu fire on August 26, 2008 09:06 PM

Faith healers are absolute frauds. The practice nothing more than predatory snake medicine.

Posted by ryan on March 17, 2010 04:59 PM

Of coarse prayer works. It is all the "junk" in between that gets in the way.

Posted by Sandra on June 9, 2010 04:31 AM

He's a total fraud. At his "clinic" he charges insane amounts and only accepts check or cash. I think the IRS should check in on that.

Preying on the sick is not looked highly upon by God.

Posted by Robert M on June 29, 2010 05:59 PM

I think the mind has an amazing ability and capacity to instinctively know what it needs and to self heal to a degree. It is established that thoughts create chemical reactions within the brain that instigate change and can therefore be used for healing. Whether you call those thoughts prayers, beliefs, hopes - does that really matter? But unfortunately as with just about any profession and any walk of life, there are those that take advantage of others.

Posted by Davina on November 2, 2010 06:08 AM

We all know the power of the placebo effect. The power of the mind and belief has a clear effect on outcome. Prayer and expectation both have been shown to have a strong effect on healing outcomes. It is when we go from the domain of enhancing the effects of a time-tested treatment into the realm of complete sham that the ethical boundaries get tested.

Posted by Jon-Erik Lido, L.Ac. on December 10, 2010 09:07 PM

I do see an ethical problem in claiming to be a "faith healer" if you don't believe in God.

It seems that by hanging that shingle, you are in effect false advertising.

I'd rather have someone who genuinely believes he can channel divine energies for healing give it his best shot and fail than have some flat out lie to me and hope to deceive me into helping myself.

The subconscious is a powerful thing. I wouldn't be surprised if on some level people would sense the deceit and so shut themselves off to the possibility of receiving help in whatever means it came, be it placebo, the power of suggestion, or honest-to-god, God-healing!

Posted by Leo on February 26, 2011 03:39 AM

Faith healing, call it fate healing, we leave it to fate don't we? When people reach for a cure and a doctor or medical practitioner is not one of the choices, it is then left to fate.

Posted by Venapro on April 4, 2011 04:31 PM