praying with patients

When and How to Pray with When and How to Pray with PatientsPatients

Bradley K. Farris, M.D.Bradley K. Farris, M.D.Professor, OphthalmologyProfessor, Ophthalmology

Adjunct Professor, Neurology & NeurosurgeryAdjunct Professor, Neurology & NeurosurgeryUniversity of Oklahoma School of MedicineUniversity of Oklahoma School of Medicine

Dean McGee Eye InstituteDean McGee Eye Institute

DisclaimerDisclaimer

I am a ChristianI am a Christian I view the world and its contents through the I view the world and its contents through the

eyes of a Christianeyes of a Christian I am a Neuro-OphthalmologistI am a Neuro-Ophthalmologist

– I see patients with difficult visual/neurological I see patients with difficult visual/neurological problemsproblems

I have offered prayer to every new patient in I have offered prayer to every new patient in my clinic for the past 20 yearsmy clinic for the past 20 years

The Tripartite BeingThe Tripartite Being

Man consists of:Man consists of:– BodyBody

That which we are physically attempting to healThat which we are physically attempting to heal Our anatomy/neuro-anatomy/physiologyOur anatomy/neuro-anatomy/physiology

– SoulSoul That which we are emotionally attempting to comfortThat which we are emotionally attempting to comfort Our mind/emotions/willOur mind/emotions/will

– SpiritSpirit That which is within us, and many believe, is guiding That which is within us, and many believe, is guiding

usus

Law, Ethics, and MoralityLaw, Ethics, and Morality

LawLaw– Behavior mandated government which Behavior mandated government which mustmust be obeyed be obeyed– Laws change from time to timeLaws change from time to time

EthicsEthics– Behavior mandated by society which Behavior mandated by society which shouldshould be obeyed be obeyed– Ethics change from time to timeEthics change from time to time

MoralityMorality– Behavior mandated by GodBehavior mandated by God– Morals Morals nevernever change with time change with time

Why Offer Prayer with a Patient?Why Offer Prayer with a Patient?

If a physician is a Christian:If a physician is a Christian:– He/She presumes to believe their “textbook”He/She presumes to believe their “textbook”– James 5:13-16James 5:13-16

““Is any among you suffering? Let him pray. Is Is any among you suffering? Let him pray. Is anyone cheerful? Let him sing praises. Is anyone anyone cheerful? Let him sing praises. Is anyone among you sick? Let him call for the elders of the among you sick? Let him call for the elders of the church, and let them pray over him, anointing him church, and let them pray over him, anointing him with oil in the name of the Lord; and the prayer with oil in the name of the Lord; and the prayer offered in faith will restore the one who is sick, and offered in faith will restore the one who is sick, and the Lord will raise him up…The effective prayer of a the Lord will raise him up…The effective prayer of a righteous man can accomplish much.”righteous man can accomplish much.”

Why Offer Prayer with a Patient?Why Offer Prayer with a Patient?

If the Physician is non-Christian believer:If the Physician is non-Christian believer:– His/Her faith may believe similar to that of His/Her faith may believe similar to that of

ChristiansChristians The power of healing prayerThe power of healing prayer

Why Not Offer Prayer?Why Not Offer Prayer?

There is concern that the patient may not There is concern that the patient may not appreciate or want the offerappreciate or want the offer– The fear of rejection is a powerful motivatorThe fear of rejection is a powerful motivator

There is fear of retaliation by the patientThere is fear of retaliation by the patient– Filing complaints/lawsuitsFiling complaints/lawsuits

Who Benefits from the Prayer?Who Benefits from the Prayer?

The PatientThe Patient– Those of faithThose of faith– Those of borderline faithThose of borderline faith– Those seeking answers about faithThose seeking answers about faith

The Patient’s FamilyThe Patient’s Family– Healing and comforting are their prioritiesHealing and comforting are their priorities

The PhysicianThe Physician– The gratitude shown by patients is overwhelmingThe gratitude shown by patients is overwhelming

The Medical Support StaffThe Medical Support Staff– They see an intimacy of caring They see an intimacy of caring

Short Term Benefits to PrayerShort Term Benefits to Prayer

You demonstrate your sincerity in your careYou demonstrate your sincerity in your care A deeper relationship is establishedA deeper relationship is established

– Patient loyaltyPatient loyalty– Patient trustPatient trust– Family loyalty and supportFamily loyalty and support

Physician-patient connection begins that can help Physician-patient connection begins that can help overcome emotional obstacles to a healthier overcome emotional obstacles to a healthier lifestylelifestyle

Long Term Benefits to PrayerLong Term Benefits to Prayer

Patient compliance is improvedPatient compliance is improved Family more eager to be involved in careFamily more eager to be involved in care Hope is established beyond medical/surgical Hope is established beyond medical/surgical

assurances or disappointmentsassurances or disappointments An An openingopening is initiated to begin addressing is initiated to begin addressing

other issues in their life that may require other issues in their life that may require spiritual counselingspiritual counseling

Pitfalls in Offering PrayerPitfalls in Offering Prayer

Physician Initiated:Physician Initiated:– Implied Coercion Implied Coercion – Patient discomfortPatient discomfort

Patient Initiated (not uncommon):Patient Initiated (not uncommon):– Differing beliefsDiffering beliefs– Physician discomfortPhysician discomfort

When to Offer PrayerWhen to Offer Prayer

NeverNever AlwaysAlways SometimesSometimes


NeverNever– EasyEasy if physician is agnostic or atheist if physician is agnostic or atheist– Relatively easyRelatively easy if physician is a “non-practicing if physician is a “non-practicing

believer” of a certain faithbeliever” of a certain faith– DifficultDifficult to come to terms with if the physician is to come to terms with if the physician is

a believer in the power of prayer in their a believer in the power of prayer in their respective faithrespective faith Why would they not want to utilize this potential Why would they not want to utilize this potential

power in their medical practice?power in their medical practice?


Sometimes: Sometimes: – Presumption that the physician is a believerPresumption that the physician is a believer

When the patient is of same belief:When the patient is of same belief:– May be unknown without asking (wearing cross)May be unknown without asking (wearing cross)– Spiritual assessment can be helpfulSpiritual assessment can be helpful

When the patient is in a medical crisis:When the patient is in a medical crisis:– Patient’s perception or physician reality?Patient’s perception or physician reality?– Pre-op or in ICUPre-op or in ICU

When there is significant fear in patient:When there is significant fear in patient:– Fear of brain tumor/cancer/blindness/memory lossFear of brain tumor/cancer/blindness/memory loss

Fear is Fear is extremelyextremely common in my clinic common in my clinic Some fears may Some fears may not be recognizednot be recognized or or admittedadmitted

When the physician needs help:When the physician needs help:– Subspecialty consultation failsSubspecialty consultation fails– Why not pursue Why not pursue super-subspecialtysuper-subspecialty consultation! consultation!

When to Offer Prayer When to Offer Prayer

AlwaysAlways– It can be difficult to assess the presence and It can be difficult to assess the presence and

depth of depth of fearfear in a short time in a short time– It can be difficult to assess who will receive or It can be difficult to assess who will receive or

reject an offer of prayer (>99% accept)reject an offer of prayer (>99% accept)– Even when accepting the offer Even when accepting the offer

unenthusiastically, many have a deep spiritual unenthusiastically, many have a deep spiritual experience that they never forget (letters)experience that they never forget (letters)

– Why wouldn’t the believing physician want the Why wouldn’t the believing physician want the help of God in help of God in everyevery patient? patient?

Asking God for HelpAsking God for Help

When you need God:When you need God:– Mark 11:24Mark 11:24

““Therefore I say to you, all things for which you pray Therefore I say to you, all things for which you pray and ask, believe that you have received them, and and ask, believe that you have received them, and they shall be granted you.”they shall be granted you.”

When God seems distant:When God seems distant:– Romans 8:28Romans 8:28

““And we know that God causes all things to work And we know that God causes all things to work together for good, to those who love God, to those together for good, to those who love God, to those who are called according to His purpose.”who are called according to His purpose.”

Personal ExperiencesPersonal Experiences

““It never ceases to amaze me the spiritual It never ceases to amaze me the spiritual need and comfort that people need and comfort that people desiredesire, and , and are so gracious and broken when are so gracious and broken when receivingreceiving it from a physician.”it from a physician.”– ““I have never had a physician do that for me.”I have never had a physician do that for me.”

““Even when I cannot help someone’s failing Even when I cannot help someone’s failing vision, they almost always are comforted by vision, they almost always are comforted by the the physicalphysical and and spiritualspiritual touch of a prayer.” touch of a prayer.”

Seeing and BelievingSeeing and Believing

““Seeing is Believing”Seeing is Believing”– It is not believed unless seenIt is not believed unless seen

““Believing is Seeing”Believing is Seeing”– Hebrews 11:1Hebrews 11:1

““Now faith is the assurance of things hoped for, the Now faith is the assurance of things hoped for, the conviction of things not seen.”conviction of things not seen.”

How I offer Prayer to PatientsHow I offer Prayer to Patients

Complete History and PhysicalComplete History and Physical Spend considerable time explaining all issues of the Spend considerable time explaining all issues of the

medical evaluationmedical evaluation Ask if the patient/family has any questionsAsk if the patient/family has any questions Ask them again Ask them again Thank the patient/family for their trust in my careThank the patient/family for their trust in my care Offer a handshake of thanks while still seatedOffer a handshake of thanks while still seated Ask the patient if they would be offended if I prayed for Ask the patient if they would be offended if I prayed for

them while informing them that I am Christian them while informing them that I am Christian Respect and be sensitiveRespect and be sensitive their response their response

Patient Responses to PrayerPatient Responses to Prayer

20 years of experience:20 years of experience:– Handful of patients responded Handful of patients responded negativelynegatively– Thousands of letters, phone calls Thousands of letters, phone calls positivepositive– Jews/Muslims/Hindus have all been very encouraging, Jews/Muslims/Hindus have all been very encouraging,

and have consistently asked for more prayer on returnand have consistently asked for more prayer on return– If a patient responds negatively, I ask their forgiveness If a patient responds negatively, I ask their forgiveness

for possibly having offended themfor possibly having offended them I am “quick” to take a humble stanceI am “quick” to take a humble stance They have always stated “no offense taken”, and seem to They have always stated “no offense taken”, and seem to

appreciate my sincerity.appreciate my sincerity.

My Christian Prayer ModelMy Christian Prayer Model

Give thanks for the health/vision presentGive thanks for the health/vision present Ask for guidance in diagnosis/treatmentAsk for guidance in diagnosis/treatment Ask for specific supernatural healingAsk for specific supernatural healing Give thanks for any divine benefitGive thanks for any divine benefit Ask that the patient’s needs be met in spirit, Ask that the patient’s needs be met in spirit,

soul, and body (covering the bases)soul, and body (covering the bases) Pray to the God of Abraham, Isaac, and Pray to the God of Abraham, Isaac, and

Jacob, in Jesus’ nameJacob, in Jesus’ name

““Patient Perception of Preoperative Christian Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Based Prayer in the Setting of Elective

Outpatient Surgery”Outpatient Surgery” Prospective study with IRB approval to Prospective study with IRB approval to

review the subjective response to offered review the subjective response to offered prayerprayer

Two surgeons agreed to a standard Two surgeons agreed to a standard Christian prayer structure pre-operatively Christian prayer structure pre-operatively offered to all patientsoffered to all patients

All patients were then sent a survey as to All patients were then sent a survey as to their opinion on the benefit of the prayer their opinion on the benefit of the prayer offeredoffered


Outpatient Surgery”Outpatient Surgery” 567 patients mailed an IRB approved survey567 patients mailed an IRB approved survey 11/2003 – 2/200511/2003 – 2/2005 300 were collected (53%)300 were collected (53%) Average age 35.8 Average age 35.8

– 361 (64%) were age 18 or older361 (64%) were age 18 or older– Younger patients had guardian mailingsYounger patients had guardian mailings

1 initiated the prayer1 initiated the prayer– 299 total in study299 total in study


Outpatient Surgery” – The PrayerOutpatient Surgery” – The Prayer ““Dear God, I thank you for (name of patient) Dear God, I thank you for (name of patient)

and ask you to bless (his/her) surgery. I and ask you to bless (his/her) surgery. I pray that the surgery will go well without any pray that the surgery will go well without any problems or complications and that no more problems or complications and that no more surgery will be needed. And I pray that You surgery will be needed. And I pray that You meet (name of patient)’s needs in body, meet (name of patient)’s needs in body, soul, and spirit. In Jesus’ name. Amen.”soul, and spirit. In Jesus’ name. Amen.”


Outpatient Surgery” – The SurveyOutpatient Surgery” – The Survey Did your doctor offer to pray with you before your operation?Did your doctor offer to pray with you before your operation? Did you accept the prayer?Did you accept the prayer? Did you want to accept the prayer?Did you want to accept the prayer? Did you feel free to reject the prayer?Did you feel free to reject the prayer? If someone other than your doctor had offered to pray with you, would you have accepted?If someone other than your doctor had offered to pray with you, would you have accepted? How would you classify your religious beliefs?How would you classify your religious beliefs? ____ Agnostic (not committed to belief or unbelief in the existence of a God)____ Agnostic (not committed to belief or unbelief in the existence of a God) ____ Atheist (disbelief in the existence of a God) ____ Atheist (disbelief in the existence of a God) ____ Buddhist ____ Buddhist ____ Christian____ Christian ____ Jewish____ Jewish ____ Mormon ____ Mormon ____ Muslim____ Muslim ____ Other: Please specify _________________ Other: Please specify _____________ Please indicate your opinion concerning prayer offered before outpatient surgeryPlease indicate your opinion concerning prayer offered before outpatient surgery The following questions required a response as to whether they strongly agreed, agreed, were neutral, disagreed, or strongly The following questions required a response as to whether they strongly agreed, agreed, were neutral, disagreed, or strongly

disagreed.disagreed. I believe the prayer affected the surgical result in a positive way.I believe the prayer affected the surgical result in a positive way. I felt uncomfortable when the surgeon offered to pray for me.I felt uncomfortable when the surgeon offered to pray for me. I felt that the prayer was being offered for my wellbeing.I felt that the prayer was being offered for my wellbeing. I was offended that the prayer was Christian-oriented.I was offended that the prayer was Christian-oriented. I felt that the prayer was solely intended to alter my opinion of the surgeon.I felt that the prayer was solely intended to alter my opinion of the surgeon. I would rather not have been offered prayer.I would rather not have been offered prayer. I am glad I received prayer from my physician.I am glad I received prayer from my physician. I would like to have prayer from my doctor again.I would like to have prayer from my doctor again. I believe doctors should not address spiritual issues.I believe doctors should not address spiritual issues. I believe the prayer affected my relationship with my physician in a positive way.I believe the prayer affected my relationship with my physician in a positive way.

““Patient Perception of Preoperative Christian Patient Perception of Preoperative Christian Based Prayer in the Setting of Elective Based Prayer in the Setting of Elective Outpatient Surgery” – Results (n=299)Outpatient Surgery” – Results (n=299)

284 Christian 284 Christian – 5 Baptist, 5 Baptist, – 3 Catholic3 Catholic– 4 Pentecostal4 Pentecostal– 2 Messianic Jews 2 Messianic Jews

5 agnostic 5 agnostic 2 between agnostic and atheist2 between agnostic and atheist 2 atheist2 atheist 1 Buddhist1 Buddhist 1 Baha’I1 Baha’I 1 Jehovah’s Witness. 1 Jehovah’s Witness.


Outpatient Surgery” - ResultsOutpatient Surgery” - Results 567 patients mailed an IRB approved survey567 patients mailed an IRB approved survey 300 were collected (53%)300 were collected (53%) 1 initiated the prayer1 initiated the prayer 297/299 accepted prayer (atheist/JW)297/299 accepted prayer (atheist/JW) 12/297 patients felt they were not free to reject the prayer, yet…12/297 patients felt they were not free to reject the prayer, yet…

– 11/12 agreed or strongly agreed that the surgical results were affected in a positive 11/12 agreed or strongly agreed that the surgical results were affected in a positive wayway

– 11/12 felt the prayer was being offered for their well-being11/12 felt the prayer was being offered for their well-being– 11/12 were glad that the prayer was offered11/12 were glad that the prayer was offered– 11/12 felt that the prayer offer affected their relationship with the surgeon in a 11/12 felt that the prayer offer affected their relationship with the surgeon in a

positive waypositive way 10/297 would not have accepted the prayer from anyone other than the 10/297 would not have accepted the prayer from anyone other than the

surgeonsurgeon– 6/10 were classified as Christian6/10 were classified as Christian

281/298 agreed or strongly agreed that the surgical results were affected in a 281/298 agreed or strongly agreed that the surgical results were affected in a positive waypositive way– 2/298 responses strongly disagreed that the results were affected in a positive way2/298 responses strongly disagreed that the results were affected in a positive way


Outpatient Surgery”Outpatient Surgery” What did we learn?What did we learn?

– ““You cannot please all of the people all of the You cannot please all of the people all of the time”time”

– Our goal was to heal when possible, but always Our goal was to heal when possible, but always offer an attempt at comfortingoffer an attempt at comforting

– The vast majority appreciated the offer of prayerThe vast majority appreciated the offer of prayer 297/299 (99.3%)297/299 (99.3%)

Is it Lawful to Pray with Patients?Is it Lawful to Pray with Patients?

YesYes There is no specific law prohibiting praying There is no specific law prohibiting praying

with patientswith patients

Is it Ethical to Pray with Patients?Is it Ethical to Pray with Patients?

The Physician’s PerspectiveThe Physician’s Perspective–The AMA Principles of Medical EthicsThe AMA Principles of Medical Ethics

Step #6Step #6– “ “A physician shall, in the provision of A physician shall, in the provision of

appropriate patient care, except in appropriate patient care, except in emergencies, emergencies, be free to choose whom tobe free to choose whom to serveserve, with whom to associate, , with whom to associate, and the and the environment in which to provide medical environment in which to provide medical services.”services.”

Is it Ethical to Pray with Patients?Is it Ethical to Pray with Patients?

The Patient’s PerspectiveThe Patient’s Perspective– Fundamental Elements of the Patient-Fundamental Elements of the Patient-

Physician RelationshipPhysician RelationshipRight #3Right #3

–The patient has the right to courtesy, The patient has the right to courtesy, respect, dignity, responsiveness, and respect, dignity, responsiveness, and timely attentiontimely attention to his or her needs. to his or her needs.

Is it Moral to Pray with PatientsIs it Moral to Pray with Patients

Morality is clearly a Morality is clearly a faith faith based issuebased issue For many physicians, it may be For many physicians, it may be immoralimmoral not not

to offer prayer to patientsto offer prayer to patients After 20 years of practicing faith based After 20 years of practicing faith based

medicine, the consequences of my actions medicine, the consequences of my actions have resulted in a robust, large, loyal patient have resulted in a robust, large, loyal patient base that is a joy to serve on a daily basisbase that is a joy to serve on a daily basis

Thank You!Thank You!

Questions?Questions?

praying with patients

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