Most people have faith that faith can heal. According to a poll published in The Lancet, 79% of adults believed that spiritual faith can help people recover from a disease. In a CDC study, 45% of respondents reported using prayer for health reasons in the previous 12 months. Even doctors are convinced: a poll of family physicians showed that 99% believe religious beliefs can heal, and 75% believe the prayers of others can promote a patient’s recovery. They are wrong. Despite impressive testimonials, the “miracles” that support canonization of Catholic saints, and a few flawed, unreplicated studies in the medical literature, there is no credible scientific evidence that faith can cure or that intercessory prayer improves outcomes. But there is plenty of evidence of harm from relying on faith in lieu of medical care.
It’s sad when people reject proven treatments and turn to ineffective alternatives like homeopathy, bogus cancer “cures,” and psychic surgery; but it’s even sadder when people reject medical care entirely. Some people deny the existence of illness, or even deny that the material world is real. Christian Science philosophy holds that “There is no life, truth, intelligence, or substance in matter…. Therefore, man is not material. He is spiritual.” They believe illness is an illusion created by thought and curable by thought, and they reject all forms of medical treatment or any acknowledgement that an illness is present. Christian Science practitioners come to the home to pray (and charge for their services). Christian Science “nurses” are trained in metaphysics, not medicine; they are not even allowed to use a thermometer.
Christian Science numbers have dwindled, but they are still exerting a disproportionate influence on legislation and are endangering children. Sometimes they even have an impact on public health, endangering all of us.
In 1985, a Christian Science “nurse” at Principia College—a Christian Science institution—contacted an Illinois public health official to report that the death of a 17-year-old student might have been due to measles. On investigation, they found 16 students in the infirmary with fevers and a measles-like rash; they were not being quarantined. Investigators needed to confirm the diagnosis with blood tests. A student would agree to a blood test, but then would change his mind after talking to school officials. They wouldn’t even agree to throat swabs for viral isolation. When investigators interviewed patients and asked how long they’d had the rash, they would answer “What rash?” Students covered mirrors with towels so they wouldn’t have to see the rash, because illness meant their mind was not right with God. When investigators tried to make home visits, patients were hidden by moving them from house to house. It was weeks before they finally got a confirmatory blood sample from a non-believer who had contracted the illness from her Christian Scientist brother.
Before the outbreak was contained, there were 125 confirmed cases (15% of the school population) and 3 deaths: a case fatality rate of 2.4% compared to a national case fatality rate of 0.01%. They didn’t learn from the experience. Only 9 years later, in 1994, the school had another measles outbreak with 247 cases (there were only 934 cases in the entire country that year!). And there have been two other smaller outbreaks at the school since then, as well as at least two outbreaks at Christian Science camps. Measles was eradicated in the U.S. by 2000; outbreaks since then are due to international travel and a degradation of herd immunity from vaccine refusal. Most recent outbreaks have been associated with religious groups that value faith over vaccines. A 2013 measles outbreak in a vaccine-skeptical Texas megachurch occurred when an unvaccinated church member returned from Indonesia with the disease; the pastor gave a mixed message, setting up vaccine clinics but saying “So I’m going to tell you what the facts are, and the facts are the facts, but then we know the truth. That always overcomes facts.”
Christian Science is just the tip of the iceberg. Several religions discourage vaccines and medical care. Faith healing is practiced by Pentecostals, the Church of the First Born, the Followers of Christ, and myriad smaller sects. They typically reject all medical treatment in favor of prayer, laying on of hands, anointing with oils, and sometimes exorcisms. A 2013 book by Cameron Stauth, In the Name of God: The True Story of the Fight to Save Children from Faith-Healing Homicide, provides chilling details about children who died from denial of medical care. Children writhing in pain, unable to eat, convulsing, and slipping into comas; appendicitis with rupture and peritonitis; deformities from huge tumor masses; necrosis of the bowel resulting from a simple hernia; lifelong ill health and death from kidney failure at age 16 from a congenital defect that surgery could easily have fixed. It makes for painful reading.
Believers are uninformed about health and unable to recognize emergencies. In one case, when a baby developed convulsions, they thought it was a sign of improvement: “Look! He’s more active.” A girl in a diabetic coma was breathing noisily; when her breathing quieted they thought it meant she was getting better. It didn’t. It meant her body systems were failing and she was about to die.
In 1998, a study in the medical journal Pediatrics, “Child Fatalities from Religion-motivated Medical Neglect,” documented 172 faith-healing deaths involving 23 different sects in 34 states. The true numbers were undoubtedly much higher, and some deaths are never reported. In most of these cases the prognosis would have been excellent with medical care. The lead author, pediatrician Seth Asser, characterized some of the cases as babies literally being tortured to death.
In 1977, Rita Swan resigned from the Christian Science Church after her baby died of meningitis. She discovered preventable deaths of Christian Science children from meningitis, diabetes, diphtheria, measles, kidney infection, septicemia, cancer, and appendicitis. She dedicated her life to preventing the deaths of other children from faith healing, founding the organization Children’s Healthcare Is a Legal Duty (CHILD) and campaigning across America against laws that shielded religious parents from prosecution for child neglect, abuse, and murder. It was literally legal to murder a child as long as religious beliefs were involved.
It wasn’t just children. Did you think Semmelweis ended puerperal sepsis? Followers of Christ women give birth at home attended only by unqualified midwives. During one delivery, the father cut an episiotomy with dirty scissors; the mother died of infection. In that sect, women have no voice: they are required to leave all decisions to their husbands, no matter how frightened they may be when something goes wrong. Their home birth practices have resulted in 900 times the maternal mortality and 26 times the infant mortality of the general population. Adults are dissuaded from seeking medical care even in emergencies. One elderly male with heart failure was forcibly restrained by two adult sons to prevent him from going to the hospital.
In Oregon, a 2011 law finally eliminated religious beliefs as a legal defense, allowing prosecutors to seek murder charges against parents who deny their children medical care for religious reasons. Later that year, Dale and Shannon Hickman were sentenced to 6 years for second-degree manslaughter in the death of their infant son, prematurely born at home and denied medical care when he obviously had trouble breathing. Unfortunately, religious shield laws still exist in every other state except Hawaii, Nebraska, Massachusetts, Maryland, and North Carolina.
Oregon law still has religious shields for caregivers of dependent adults, and it still allows religious exemptions for immunizations, metabolic screening (for conditions like PKU), newborn hearing screening, vitamin K and prophylactic eye drops for newborns, and bicycle helmets (where is that in the Bible?). Every state but Mississippi and West Virginia allows religious exemptions for vaccinations.
Believers in faith healing think they have seen cures, but these are mostly misinterpretations of ordinary recoveries from common illnesses. Misdiagnoses and misunderstandings are common. When patients get better, confirmation bias powerfully reinforces their beliefs; and when someone dies, it’s God’s will, not a failure of faith healing. Either way, belief triumphs over reality; and there is strong peer pressure from their close-knit religious communities. Faith “healings” have never been confirmed by a single independent scientific study. When that was pointed out at a hearing in Wisconsin, a woman passed a note saying “See Mark chapter 5. What more scientific proof do you need?”
Freedom of religion must be balanced against the duty of the State to protect children. Patient autonomy is one of the foundational principles of medical ethics: adults may reject lifesaving medical care for themselves because of their religious beliefs. But that doesn’t extend to denying essential medical care to their children. The courts have mandated blood transfusions for the children of Jehovah’s Witnesses and chemotherapy for children with cancer, and in some jurisdictions they have prosecuted parents for murder, manslaughter, and endangerment when a child has died without medical care. In a Pennsylvania case, parents already on probation for the death of one child from untreated pneumonia were jailed when they allowed a second child to die from the same condition.
Believers in faith healing think they are doing what is truly best for their children. They accept the death of children as unavoidable due to God’s will. They are victims too. Education in science and critical thinking might have prevented some of these tragedies. Giving the law teeth in more states might prevent many more. And removing religious exemptions for vaccination would protect our public health.
This article was originally published as a SkepDoc column in Skeptic magazine.