Loading ...

If you have never asked if you can pray for a patient, you might be in the minority.

In a recent Medscape column, Andrew N. Wilner, MD, related the story of a physician offering to pray for his wife at the conclusion of a routine visit. She had no previous relationship with the clinician and only a minor complaint. Wilner found the physician’s action disturbing and wrote in his column that while there might be situations where prayer would be appropriate, his wife’s visit did not fit in that category.

Some readers took issue with Wilner’s response.

Pro-Prayer Responses

“I don’t see how your spouse’s provider was out of line,” said one physician commenter, adding that he saw it “as an offer of generosity.” He added that medicine is more than just science and that “prayer offers us humility, and without humility in this profession we will fail.”

Another doctor said, “There were times that I sensed a patient desired more support than what I could medically give,” and that he would often “request permission to pray for them at the end of a visit.” Most patients were grateful that he considered their spiritual needs, he wrote.

In response to a Medscape Medical News poll accompanying Wilner’s column, half of the more than 2000 respondents said they had offered to pray for a patient. More than half — 56% — said they believed it was appropriate for a physician to ask to pray for a patient, but only if the patient is terminal and religious. Another 10% said it was appropriate solely if the patient was religious, and an additional 4% said they would consider it appropriate if a patient was dying imminently. Just under one third said they did not think it was ever appropriate.

Wilner said he was surprised that half of clinicians polled said they’d offered to pray. He told Medscape Medical News that in his training across the United States and internationally, “I had never seen a doctor offer to pray for a patient,” although he has on occasion joined a family’s prayers when invited.

The physician who offered to pray for his wife did so in a very well-meaning manner, said Wilner. But Wilner was not swayed by commenters who felt it was appropriate. His gut feeling, backed up by additional research and discussions with an ethicist, was that his wife’s physician acted inappropriately. The doctor did not have any prior knowledge of or interactions with his wife, she did not have a grave illness, and she was not in a good position to refuse the prayer because it was an asymmetric relationship, said Wilner.

He thinks there are a lot of considerations to weigh before a doctor should ask. “Prayer is very personal, and religious beliefs are very, very personal,” said Wilner, adding that “For some people, they’re profound.”

Others might be agnostic, and it is not likely possible to know all of this if there is no prior patient-doctor relationship, said Wilner.

Ethicists Weigh in

“I don’t think [prayer] should be out of hand dismissed as categorically inappropriate,” said Benjamin Frush, MD, a postdoctoral research fellow in the McDonald Agape bioethics fellowship at the Kennedy Institute of Ethics at Georgetown University, Washington, DC. But he told Medscape Medical News, “It has to be something that’s done thoughtfully, carefully, and respectfully” and should “seek to avoid any degree of perceived coercion or over-proselytizing.”

Context is key, he said. Frush identifies as a religious clinician but said that if he has a routine interaction with a patient who is not gravely ill and with whom he does not have a prior relationship, “I would not think those circumstances conducive to necessarily engaging in prayer, as a matter of course,” he said.

Frush said that on the very few occasions he had prayed with a patient, however, “it seems like it’s accepted as something that’s either benign or well-received.”

Ronald W. Pies, MD, professor emeritus of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University, Syracuse, New York, is the ethicist Wilner consulted about his wife’s case. Pies said that given that the doctor did not know the patient or her religious beliefs, “it was somewhat presumptuous” for the clinician to have asked to pray for her.

He raised a potential harm, also. “Even if the physician minimizes the seriousness of the patient’s condition, some patients might be a bit unnerved by the offer — wondering, in effect, ‘What’s this doctor not telling me about my condition? Am I in serious trouble?’” he wrote to Medscape Medical News.

Pies wrote that he had “real doubts about the ethics of what this physician did,” but he did not think “that she acted improperly or unethically.”

Pushback and Private Prayers

Some readers also had doubts.

“I would have zero confidence in a physician who believes in their magic sky wizard instead of mine,” commented one doctor. “Praying for someone is like self-stimulation while thinking of someone. It makes the person praying feel good but does nothing for the person they are thinking about.”

Another commenter said, “I don’t go to religious leaders for medical care, and I don’t go to medical providers for spiritual care.”

Religious clinician and ethicist Frush agreed that patients don’t “primarily come to physicians seeking spiritual care.” That doesn’t prevent a clinician “from attending to the spiritual components of patients they care for,” he said. But he added that “by praying with the patient, as a physician, you’re presuming to be a spiritual expert.”

Offering to pray “presumes that I have some authority as a prayer person that this is going to do the patient some extra good,” agreed Wilner.

Some readers commented that they pray, but privately, and suggested that it could and should be done privately. A nurse said that healthcare professionals can pray “without announcing or making a show of it, quietly, in our own hearts.” She added, “Praying with or over a patient should occur only at the patient’s request.”

Another physician said professionals could privately pray “that you offer the best care.”

Many commenters lauded the doctor in Wilner’s example for having “asked permission” to pray first, while at least one said that Wilner’s wife could have refused.

But both Wilner and Frush noted the power dynamic between doctor and patient. “A physician has a degree of power, based on his or her expertise,” said Frush. “The physician needs to be incredibly thoughtful and certainly never seek to abuse or coerce that to their advantage,” he said.

He also suggested making use of a hospital chaplain when a prayer might seem appropriate, at least in the inpatient setting. They have training and a kind of cultural competency that is not typically in the physician’s toolbox, said Frush.

“My role is to help the patient, and whether I’m religious or not religious, or the same faith of the patient, I think that’s very secondary to the patient’s needs,” said Wilner. But, he said, “If a patient approached me and said, ‘Dr Wilner, will you pray with me?’ I would say, absolutely, yes.”

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in many health and science publications, including Smithsonian.com. You can find her on X @aliciaault and on Bluesky @aliciaault.bsky.social.