ShareThisIn this season of believing, it's a good time to take a look at some of the current science of faith and medical miracles.
Numerous surveys of both doctors and the general public show that many believe that prayer and divine intervention can help a patient.
Surveys done earlier this month by HCD Research found that physicians are only slightly less religious or likely to believe in miracles than the general public.
In particular, 70 percent of docs and 85 percent of the public agreed that miracles are possible today, and 39 percent of physicians, versus 45 percent of the public, said that some patients experience miraculous recoveries, unexplained by scientific evidence.
Half of doctors and three-quarters of the public said they sometimes pray for someone else.
Still another survey, done in 2005 and published last summer in the Archives of Surgery, focused on trauma patients, and was somewhat less positive. Fifty-seven percent of the public, and only 20 percent of doctors and other medical workers, agreed that God could save a gravely injured or ill family member even if doctors said further attempts to treat the patient were futile.
The authors of the second study said the disparity underscores the need for trauma doctors and surgeons to be sensitive when dealing with families of patients that medical evidence demonstrates have no chance of survival. This is particularly true as more trauma patients survive to reach a hospital despite massive injuries that would have been fatal at the scene a decade or so ago.
Most doctors engage in some internal battles between faith and science on a regular basis.
Even when death is not imminent, for a variety of reasons, medicos are under constant pressure to "do something" for a patient, even when in their expert opinion, treatment is unlikely to work.
Yet they're also aware of studies that show patients are more likely to respond positively to a treatment if the patient believes it will work -- and part of that positive attitude requires that the doctor appear confident, too.
So do they doggedly stick with truthfulness to a patient, or give him or her pills or other treatments that they don't think will work, but might if the patient thinks they will.
Although the response rate varies depending on the medical problem being addressed, medical literature going back to the 19th century suggests that about a third of patients will gain some positive benefit from a placebo.
And surveys of doctors -- including several done this year -- show that about half admit administering placebos to patients at least sometimes, if not regularly.
What's daunting in those reports -- particularly one published in the British Medical Journal last fall -- is that very few docs actually give patients sugar pills anymore -- most pharmacies won't make them. Instead, doctors usually prescribe over-the-counter painkillers or vitamins that can and do have biological effects -- and even unpleasant side effects for some people.
Presumably, if the patient goes home happy and feels better, the transaction is a success.
But what if doctors could really predict which patients are susceptible to the placebo effect?
Brain imaging studies over the past several years have begun to illustrate what happens within the noggin when a patient responds to placebo -- say the release of more natural painkillers if they expect relief from pain, or increased levels of the transmitter serotonin to a region responsible for happiness and well-being in patients suffering from anxiety.
And it may be that while hope is good for everyone, when it comes to placebos, faith may reside in certain genes.
Earlier this month, Swedish scientists reported in the Journal of Neuroscience on a test of an anxiety-moderating drug that also involved a quarter of the 108 patients getting only sugar pills.
It turned out that 40 percent of the placebo group got the same degree of relief as those who took the active drug, based on brain-imaging studies done before and after eight weeks of treatment. But those who responded to the placebo were also found to have a couple of very specific variations in genes that affect the processing of serotonin in the brain.
Such information eventually could help doctors figure out which patients are more likely to respond to placebos, but might also be used to filter out the placebo effect from tests of new drugs.
On the Net: http://www.bmj.org
www.jneurosci.org
(E-mail Scripps Howard News Service health and science correspondent Lee Bowman at bowmanl(at)shns.com. Distributed by Scripps Howard News Service, http://www.scrippsnews.com)
The Medical Journal
