These reflections focus on the following topics: (1) empirical evaluations of the efficacy of intercessory prayer for recovery of health, (2) an argument about potentiality and personhood, and (3) a critique of the consistency of a pro-life position.
As contemporary debates indicate, the relationship of religion and science remains a contentious one in the minds of many scholars. In a sense, faith - which by definition is not simply knowledge - seems opposed to any kind of empirical justification. Yet at times Scripture itself seems to appeal to empirical justification in order to demonstrate the power of God. The prophet Elijah challenges the priests of Baal to pray to their god to set aflame a sacrifice, taunting them when nothing happens that perhaps their god is sleeping. Elijah vindicates his belief in the God of Abraham when, after prayer, God delivers a fiery consumption of the sacrifice (1 Kings 18: 20-39).
Scripture enjoins believers to pray for the sick. "Is any among you sick? Let him call for the elders [presbyters] of the Church and let them pray over him, anointing him with oil in the name of the Lord; and the prayer of faith will save the sick man, and the Lord will raise him up" (James 5: 14-15). Is there any empirical evidence to suggest that prayer for others does indeed aid them in regaining health?
In his article, "Just Another Drug? A Philosophical Assessment of Randomized Controlled Studies on Intercessory Prayer" (Journal of Medical Ethics, August 2006), philosopher Derek Turner takes up this topic. He appeals to philosophical and theological grounds in questioning whether such studies are ethically permissible, by (1) considering the problems of obtaining informed consent from patients participating in the studies; (2) noting that intercessors, if they act in accordance with their religious beliefs, should subvert the studies by praying for patients in the control groups; and (3) arguing that intercessors and scientists must take incompatible views of the causal relationship between prayer and healing.
Turner's article, like a host of other articles treating the possibility of prayer to promote healing,1 raises important questions about empirical demonstrations of the power of prayer. One of Turner's concerns is that believers have a religious obligation to include the control group in their prayers, thereby subverting the study. He writes:
Indeed, if I were a Christian recruited to one of the prayer teams, and if an experimenter asked me to offer specific prayers for several patients assigned to the intercessory prayer group, I would have qualms. Surely God cares about the suffering of all the patients in the study. Why should I pray for some but not for others? Would a good Christian not pray for everyone who is in need? I, at least, would be tempted to follow the experimenter's instructions, and then sneak in an extra request at the end, "Please, God, take care of those in the control group, too." Of course if the volunteers did this, that would subvert the entire study - but this is arguably what the volunteers should do, if they are Christian. (489)
This concern seems misplaced. It is true that Christians have a duty to love everyone, but this general obligation does not translate into a particular duty to help every individual. As Aquinas notes in the Summa theologiae, "absolutely speaking it is impossible to do good to every single [person]: yet it is true of each individual that one may be bound to do good to him in some particular case. Hence charity binds us, though not actually doing good to someone, to be prepared in mind to do good to anyone if we have time to spare. There is however a good that we can do to all, if not to each individual, at least to all in general, as when we pray for all, for unbelievers as well as for the faithful."2 Just as we have no obligation to donate to every single charity (despite our obligation to donate to some particular charity if we have the means), so we have no obligation to pray for every single person in particular. In the intercessory experiment, we have no obligation to pray for the control group in particular. Praying for people in general, since this would include both the control group and the intercessory group equally, does not threaten the scientific validity of the results.
Turner is correct, however, to point out that there may be still other people, not officially participating in the study at all, whose prayers render problematic the empirical findings. In other words, perhaps relatives or friends of the control group pray for them and in that way corrupt the scientific validity of the study.
The question of measuring empirically the power of intercessory prayer faces at least two obstacles unnoticed by Turner. The first is that - unlike medications that have chemically identical powers - intercessors themselves may not be equally efficacious in prayer. Scripture and tradition seem to indicate that not all persons share equally in sanctity. Why should we assume that the prayers of the devout and the lukewarm are equally efficacious? Since it is impossible to measure a person's holiness, it is impossible to control for the variations in the efficacy of prayer. In addition, even the same person may pray on one occasion with more fervor, concentration, and self-giving than on another - again, factors which may be relevant for whether a prayer is granted but which cannot be empirically measured.
Second, it is controversial (and I believe false) to assume that God's answering of prayer works in the same way as a medicine curing a disease. The chemical efficacy ofa particular medication does not depend on the free choice of an individual. By contrast, God freely chooses to grant or not grant a prayer request. God is not a divine puppet over whom, through the strings of prayer, we can exercise control. Rather, whatever it is that God wills, it is not our prayer that makes God act, again unlike a medication that makes certain chemical reactions take place. Rather, God freely wills to grant certain requests on condition that we pray for them. In other words, if we believe that God chooses freely or that God is pure actuality with no potentiality whatsoever, then prayer cannot exercise a kind of causal power over God. If an orthodox view of God is correct, it would seem to follow that one cannot measure the efficacy of prayer through any empirical test of causal effectiveness.
Taking on the central issue of personhood in "Probability Potentiality" (Cambridge Quarterly of Health care Ethics, April 2007), Christopher Nobbs attempts to chart a middle course between those who argue that personhood rests on the potentiality of a being to achieve self-awareness, and theorists such as Peter Singer who hold that personhood begins sometime after birth when self-awareness is actually achieved. Curiously unmentioned are those who disagree with both views, namely, those who hold that personhood is contingent upon neither actual self-awareness nor potential self-awareness, but rather the rational nature of the being in question. On this view, even a severely handicapped human child with no potentiality to achieve self-awareness is still a person.
Nobbs holds that actual persons must be self-aware, but also that those who are potential persons in his view - such as human babies - have some value because they are highly likely to achieve personhood. Just as a lottery ticket with a fifty-fifty chance of being worth a million dollars is extremely valuable (as calculated by rational decision theory, 50 percent x $1 million = $500,000) but not as valuable as one million dollars itself, so too the human infant is not equal to a person and yet is of such high value that parents may not neglect or kill the child because of the probability that the infant will become a person. With the application of a kind of rational decision theory to the question of when human life becomes valuable, Nobbs attempts to maintain the self-awareness view of personhood and yet not sanction the moral permissibility of infant neglect.
Several difficulties face this proposal. Obviously, the probability of an infant reaching personhood must be conceived independently of detrimental human intervention. Otherwise, parents could neglect or kill the infant at will, since the probability of such an infant reaching personhood with the harmful human intervention would be quite low, if not zero. If harmful human choices are excluded from the probability, then it is difficult to see why the human fetus - from quite early in pregnancy - would be much different than the human newborn. After a pregnancy is established, miscarriage - like still-birth or SIDS - is relatively rare, so the human fetus would seem to have a high likelihood of reaching personhood and so would have a high value. This would seem to exclude abortion save for the most serious of reasons; if not, then one would have to endorse infanticide for birth control and convenience, as takes place in most abortions. In other words, if potential value is going to do the work needed to exclude infant neglect or infanticide, it will also exclude many abortions - presumably a view that Nobbs does not want to embrace, given his endorsement of something like Singer's view of Personhood, a view typically driven by the desire to justify abortion.
Another difficulty is that in any calculus of probability and value, both terms are relevant. In other words, in terms of shifting the outcome, if a value is high enough, even a low probability yields high probability value. So in adjudicating among various options, not simply the probability but also the value involved is relevant. Considering negative outcomes, it would be irrational for me to wager even with good odds, if losing the wager would result in, say, thermonuclear devastation. Put positively, if the value of personhood is high enough, even a low probability of achieving personhood yields great value, which would again seem to lead to a condemnation of not just infanticide but also abortion. If, as Pope John Paul II states, we affirm "the incomparable value of every human person,"3 then this inestimable value shifts the probability calculus decidedly against negative interventions on human life even in the face of low probability.
Considered from another perspective, Nobbs's view of probability potentiality is unlikely to be persuasive grounds for demonstrating the problematic nature of infanticide or infant neglect to many pro-choice advocates. Commenting on her own example of a space explorer whose body contains virtually millions of potential persons, Mary Anne Warren remarked that the rights of an actual person always outweigh the rights of however many potential persons.4 If so, then it is difficult to see what practical difference it would make if infants (or other human beings) have greater value the more likely it is that they are to achieve personhood. It would still be permissible for a couple to take a vacation, leaving their newborn at home to die from neglect, since the rights and desires of actual persons could in principle never be outweighed by the rights and desires of nonpersons, however close to achieving personhood.
In his article "Pro-Life is Anti-Life: The Problematic Claims of Pro-Life Positions in Ethics,"5 John Harris, a prominent consequentialist and editor-in-chief of the Journal of Medical Ethics, critiques David Oderberg's Moral Theory: A Non- Consequentialist Approach with rhetorical fireworks characteristically reserved for partisan college newspapers.6 Harris describes Oderberg, and the pro-life view generally, as tendentious, unprincipled, hollow, hypocritical, and disingenuous. Addressing Oderberg's claim that consequentialism is the dominant approach in contemporary applied ethics, Harris retorts, "Obviously Oderberg has never been to, or even heard about, such Western countries as Italy, Spain, Portugal, Germany, France, Greece, Eire, Poland, Malta, or almost any other country of Western Europe let alone most of the United States and South America" (100). Such remarks do not contribute to the understanding of differences, the clarification of important issues, or the resolution of disagreements.
Harris's argument against Oderberg in part focuses on cases where adherence to an exception less norm against intentionally killing innocent persons leads to counterintuitive results. For example, Harris believes that the pro-life view would allow the Maltese conjoined twins Mary and Jodie to both die rather than saving one by killing the other. Or, in another example, it would be forbidden to kill a hijacker and his innocent human shield to prevent an entire plane from crashing and killing all on board.
A more careful study of the tradition under criticism indicates a more complex picture. It is true that many Catholics opposed the separation of Jodie and Mary on a number of grounds,7 but other Catholic commentators,8 myself included,9 have argued that the separation was not intentional killing and was justified according to double-effect reasoning (DER). Likewise, scholastics following Aquinas dealt explicitly with cases of attackers making use of human shields, and some held that one can defend oneself with lethal force even in such cases. Similarly, I believe that DER would permit shooting down hijacked aircraft that are being used as missiles, despite the loss of life for innocent passengers on board.
Harris misunderstands double-effect reasoning in another way: "It is a classic paradox of Catholic theology or any philosophy that employs the doctrine of double effect that since no one may intend to kill a protected individual those that do not intend to kill protected individuals are in fact permitted to do so. ... It is open season on indirect killing" (103, 106). In fact, double-effect reasoning involves more than simply the requirement that an agent not intend, as a means or an end, to intentionally kill the innocent. In addition, "indirect killing" is justified only if there is also a proportionately serious reason for allowing the side effect of death, such as defending innocent human life. DER simply does not allow "open season" for indirect killing.
Finally, since Catholic tradition sanctions the use of the death penalty and private self-defense, Harris construes the pro-life position as holding that, "no lives are intrinsically valuable - valuable because they are lives of a particular sort of creature, the lives of human beings instead of animals, as it is sometimes put, of a special 'natural kind.'We find that pro-life philosophy does not identify a class of beings whose lives are intrinsically important" (103). The pro-life position, in other words, is only pro-innocent life, and hence is inconsistent.
This critique again misrepresents its target. In Catholic theology, as John Paul II's Evangelium vitae makes clear, all human beings - without any exception whatsoever - have dignity because they are endowed by God with a soul, because they can be redeemed by God, and because they have an eternal destiny. Traditional affirmations of the right of the state to perform capital punishment are in no sense a denial of the goodness or dignity of the life of the condemned. Just as a fine presupposes the value of money, and imprisonment presupposes the value of liberty, so too capital punishment deprives a wrongdoer of something valuable and good - his own life. In cases of self-defense, on my reading of the text at least,10 Aquinas taught that one may not intend to kill the attacker but merely to stop the attack precisely because of the intrinsic value of the attacker's life. To assert that one may use whatever force is necessary to stop an attack and preserve one's own life is not to assert that the attacker's life is worthless. Left out of Harris's critique entirely are efforts of the "new natural law" advocates, led by Germain Grisez, to make the consistency of the Catholic tradition even more evident.
1 The most systematic study of this question of which I am aware is David R. Hodge, "A Systematic Review of the Empirical Literature on Intercessory Prayer," Research on Social Work Practice 17.2 (March 2007): 174-187. For a limited sample of the studies cited by Turner, see D. A. Mathews, S. M. Marlowe, F. S. MacNutt, "Effects of Intercessory Prayer on Patients with Rheumatoid Arthritis," Southern Medical Journal 93.12 (December 2000): 1177-1186; L. Leibovici, "Effects of Remote, Retroactive Intercessory Prayer on Outcomes in Patients with Bloodstream Infection: Randomized Controlled Trial," British Medical Journal 323.7327 (December 22-29, 2001): 1450-1451; R.C. Byrd, "Positive Therapeutic Effects of Intercessory Prayer in a Coronary Care Unit Population," Southern Medical Journal 81.7 (July 1988): 826-829. [Back]
2 Thomas Aquinas, Summa theologiae, II-II, Q 31.2, reply 1. [Back]
3 John Paul II, Evangelium vitae (March 25, 1995), n. 2. [Back]
4 Mary Anne Warren, "The Personhood Argument in Favor of Abortion," in Life and Death: A Reader in Moral Problems, 2nd ed., ed. Louis P. Pojman (Belmont, CA: Wadsworth, 2000), 265-266. [Back]
5 John Harris, "Pro-Life is Anti-Life: The Problematic Claims of Pro-Life Positions in Ethics," in Scratching the Surface of Bioethics, eds. Matti Hayry and Tuija Takala (New York: Rodopi, 2003): 99-109. Harris writes: "The hollowness of pro-life positions has been demonstrated in many ways and it will not be my purpose in this short paper to attempt to catalogue the ways in which such positions are so often wantonly destructive of human lives and of the value that 'life' represents. ... A further dimension of the pro-life position that has not received the critical attention its hypocrisy merits is the way in which a pro-life position does not in fact embody an uncompromising and principled stand against killing, but instead is the articulation and defense of a particular set of justifications for killing normal human beings" (100, 102). [Back]
6 David Oderberg, Moral Theory: A Non-Consequentialist Approach (Oxford: Blackwell, 2000). [Back]
7 For example, Archbishop Cormac Murphy-O'Connor, "The Conjoined Twins Mary and Jodie: Ethical Analysis of their Case," Origins 30.17 (October 5, 2000): 269-272. [Back]
8 For example, William E. May, "'Jodie'and 'Mary': Separating the Maltese Twins," National Catholic Bioethics Quarterly 1.3 (Autumn 2001): 407-416. [Back]
9 See Christopher Kaczor, The Edge of Life: Human Dignity and Contemporary Bioethics (New York: Springer, 2005), ch. 8. [Back]
10 Aquinas, Summa theologiae II-II, Q 64.7. See also Christopher Kaczor, "DoubleEffect Reasoning: From Jean Pierre Gury to Peter Knauer," Theological Studies 59 (June 1998): 297-316. [Back]