Daily Times

The word, faith, which is a noun, means “confidence or trust in a person or thing”; “belief that is not based on proof”; “belief in God or in the doctrines or teachings of religion”; “belief in anything, as a code of ethics, standards of merit, etc.”; “a system of religious belief”; “the obligation of loyalty or fidelity to a person, promise, engagement, etc.”; and “the observance of this obligation; fidelity to one’s promise, oath, allegiance, etc.”. Assorting all these various meanings, faith may be, for sake of clarity and conversation, categorized as: a secular faith and a sacred faith, in which the former relates to material matters or worldly aspects while the latter, to spiritual matters or divinely aspects.

Faith itself is found to be innate and/or built experientially and cognitively in humans, probably in other lifeforms too, which faith is reinforced by seemingly supportive signs and sensed by cognition/emotion. As an early example, during its birth, an infant cries the moment it exits the birth canal probably because the infant is suddenly displaced from the enclosed, warm, familiar, nourishing, environment of the trustworthy womb to an open, cold, unfamiliar, non-nourishing environment of the outside that is not yet trustworthy to the infant. As soon as the crying infant is picked up by the child-delivery person (doctor or nurse) and starts feeling the warmth of human hands while being cared for and cleaned/dressed up, the infant starts feeling secure and hence begins to trust the caring person and the new environment and eventually stops crying. Further, after it is handed over to the mother who caringly hugs and kisses it, the infant feels warmer and more secured, which aids in strengthening the essential trust. As such, through these primitive personal experiences, the infant starts to have a faith in the new environment and early encountered humans, which faith was probably needed by the infant for its survival or for it to feel secure after being out of the womb. This may arguably be humans’ first faith—a faith in the caring and loving mother and/or father.

Scientifically, faith is nothing but a psychophysiological and/or psychoneuroimmunological response, which, in other words, is also known as a placebo effect that is found in research and development of medicinal drugs or medical devices, which involves double-blind, placebo-controlled clinical trials conducted by drug or device researchers or developers. A placebo is an inactive substance (often a sugar pill) disguised as a medicinal drug, or a sham clinical procedure using a sham medical device. Participants in clinical trials of a medicinal drug are divided into two groups: One group, called a control group, is given a placebo in place of the drug while the other group is given the drug being researched. That way, researchers can compare the drug’s effectiveness against the placebo’s effectiveness. To further elaborate on it, a double-blind, placebo-controlled clinical trial is a research of a medicinal drug involving human participants in which neither the trial researcher, nor the trial participant knows who is getting the drug and who is getting the placebo. But other scientists or specialists who are involved in the drug research/development but not in the trial know which is a placebo-controlled group and which is a drug group. All participants who are randomly given a placebo/drug are informed of any side-effects or risks of the drug through the informed consent process which also helps protect the participants.

In a clinical trial, after administering the drug/placebo being researched, the clinical trial participants report any side effects during the follow visit by the drug study researcher or designee. It has been found that estimated 15% to 72% of the participants in the placebo-controlled group have reported the side-effects and/or cure in clinical trials of medicinal drugs or medical devices.

For examples, in the recent Pfizer’s and Moderna’s COVID-19 vaccine phase 3 trials, most side effects which were reported were mild or moderate. The adverse reactions within seven days after the second dose of the Pfizer Covid-19 vaccine, were fatigue, headache, muscle pain, joint pain, fever, and vomiting which were experienced by 24%, 25%, 7%, 6%, 1%, and 1%, respectively, of the participants in the placebo-controlled group, while they were experienced by 60%, 52%, 38%, 21%, 16%, and 2%, respectively, of the participants that had the vaccine. Similarly, the adverse reactions within seven days after the second dose of the Moderna vaccine were also fatigue, headache, muscle pain, joint pain, fever, and vomiting which were experienced by 24%, 25%, 13%, 10%, 1%, and 7%, respectively, of the participants in the placebo-controlled group, while they were experienced by 68%, 63%, 6%, 45%, 16%, and 22%, respectively, of the participants that took the vaccine  Also, the U.S. Food and Drug Administration, during the vaccine trials data reviews, pointed out that the vaccine was contributing to Bell’s palsy, which is a type of temporary facial paralysis reported by the participants in the vaccine trials. There were four cases of Bell’s palsy reported in the Moderna vaccine trial—three cases of the participants who had the vaccine and one case in the placebo-controlled group, which resolved itself.

So, from an objective observer’s perspective, the occurrence of all these side effects also called negative placebo effects or nocebo effects which were found to be temporary in the placebo-controlled group of the vaccine trials points to one thing and one thing only that is faith—confidence, belief, or trust—in the “drug” (placebo disguised as a vaccine) and/or in the study researcher who, during the informed consent process, mentioned to all the participants the side effects of taking the vaccine. Additionally, it must be noted that the adverse reactions were temporary in both the placebo-controlled group and the vaccine group. So, it can be concluded that placebo effect disappears after a certain time-period unless it is reminded or recalled just like any other faith that disappears unless it is ritually and regularly practiced. As indicated above, this category of faith may be termed as a secular faith because it relates to material matters or worldly aspects of life.

Ethically, there is, however, an issue with nocebo effects which cause a wide array of harms to drug-trial participants or patients by informing them of potential adverse events. Informed consent process is required to respect patient autonomy, but the way, the potential adverse events are mentioned could cause an additional harm, which may violate the required non-maleficence principle. While respecting the patient autonomy, the nocebo effects, however, can possibly be reduced by using, for an example, framing effect during the informed consent process. The framing technique would provide perspectives on how people organize, perceive, and communicate reality.

Moreover, the placebo effect can also produce positive effects if therapy is intended. A study published online Oct. 27, 2016, by PLOS Biology seems to have identified what goes on in the brain during a placebo effect. Researchers used functional magnetic resonance imaging to scan the brains of people with chronic pain from knee osteoarthritis. Then everyone was given a placebo and had another brain scan. The researchers noticed that those who felt pain relief had greater activity in the middle frontal gyrus brain region, which makes up about one-third of the frontal lobe. This, in general, proves that placebo effect is neither deception nor self-delusion and the people who take the placebo (sugar pill) are not lying, cheating, simple-minded, or insane; their disease symptom disappears not because they consciously wished it to disappear. This further indicates that physical changes due to the placebo effect are real and hence the placebo effect is not a subjective self-report, mood, or attitude.

The therapeutic placebo effect is a result of expectation or an outcome produced by anticipation that is created by the human brain. In other words, the placebo effect or nocebo effect is a self-fulfilling prophecy (positive or negative) and has patterns with which the brain predictably produces its own desired outcomes. Various clinical studies found that placebos follow the same dose-response curve as real medicines, that two pills give more relief than one and a larger capsule is better than a smaller one, and that placebo injections perform more effectively than placebo pills do. Also, the studies show that substances which treat one medical condition but are used as a placebo for another medical condition have a greater placebo effect than sugar pills, that the greater the pain, the greater the placebo effect—the more relief desired, the more relief attained, that a person does not have to be sick for a placebo to work, and that placebo stimulants, placebo tranquilizers, even placebo alcohols produce predictable effects in healthy subjects. But it must be noted that the effectiveness of the therapeutic placebo would be 15% to 72% as indicated above.

However, practice of therapeutic placebos that are disguised as real medication causes ethical concerns that it is deceptive and that it also could adversely affect the doctor–patient relationship in the future. There are also other concerns that legitimate doctors and pharmacists could be charged with fraud or malpractice by using a placebo. Still, another concern is that using placebos can delay the proper diagnosis and treatment of serious medical conditions. About 25% of physicians in both the Danish and Israeli studies used placebos as a diagnostic tool to determine if a patient’s symptoms were real, or if the patient was malingering. The British Medical Journal editorial said, “That a patient gets pain relief from a placebo does not imply that the pain is not real or organic in origin …the use of the placebo for ‘diagnosis’ of whether or not pain is real is misguided.” Results of a survey in the United States of more than 10,000 physicians indicated that while 24% of physicians would prescribe a treatment that is a placebo simply because the patient wanted treatment, 58% would not, and for the remaining 18%, it would depend on the circumstances.

Another example of therapeutic placebo use is homeopathy whose practitioner prescribes for numerous diseases homeopathic drugs which are sugary powders or pills with various other ingredients including aromas or essences. The House of Commons of the United Kingdom Science and Technology Committee has stated: “In the Committee’s view, homeopathy is a placebo treatment, and the Government should have a policy on prescribing placebos. The Government is reluctant to address the appropriateness and ethics of prescribing placebos to patients, which usually relies on some degree of patient deception. Prescribing of placebos is not consistent with informed patient choice…”

Other areas where a therapeutic placebo effect plays its role are herbal medicine (e.g., a Greek-type or Ayurveda herb) that is claimed to be a cure without any evidence via successful double-blind, placebo-controlled clinical trials, and faith-healing which is practiced in Christianity (Catholicism, Evangelicalism, Christian Science, and The Church of Jesus Christ of LDS), and which often involves blessings–laying on of hands and praying.  Faith-healing is also practiced in Islam, which involves reciting the Quran over water or olive oil and drinking, bathing, or anointing oneself with it, and some time placing the right hand on a place that is in pain or placing the right hand on the forehead and reciting Sura Al-Fatiha. In Hinduism, there are Ayurveda, Yoga, and Hindu godmen or gurus who perform faith healing. With the notion of the body-mind unity, a research in faith-healing indicates that there are five mechanisms that are associated with a faith-healing, which are behavioral or conative, interpersonal, cognitive, affective, and psychophysiological. However, as discussed above, the effectiveness of herbal medicine or faith-healing, either of which is a therapeutic placebo, would be 15% to 72% but temporary.

So, again, from an objective observer’s perspective, the occurrence of all these positive or therapeutic placebo effects which are found to be temporary points to one thing and one thing only that is faith—confidence, belief, or trust—in the “medication” touted as a treatment drug and/or in the doctor who during the treatment tells the patient that the “medication” would cure the disease. Additionally, it must be again noted that the therapeutic placebo effect disappears after a certain time-period unless it is reminded or recalled just like any other faith that disappears unless it is followed regularly/ritually. As indicated above, this category of faith may be termed as a secular faith because it relates to material matters or worldly aspects of life, including, but not limited to, human potentials, health, and livelihood.

A placebo effect, which is a response of confidence, belief or trust in a person or thing or words (and which is faith) is found, for examples, in promises, recitations of holy books, repetitions of holy words using tasbih or rosary beads, ritual prayers, palmistry, tarot card reading, astrology, wearing charms or amulets, praying to saints, drinking holy shrine water, or bathing in a holy river or pond. But a chance of the desired outcome of any of these practices would be 15% to 72% due to the placebo effect.

The other category of faith (placebo effect) is a sacred faith—a belief in God or in the doctrines or teachings of religion that uses (or sometime abuses) faith to establish and sustain itself and that according to various researchers, seem to fill the human need for finding meaning and sparing people from existential angst while also supporting social organization. A sacred faith which is also a placebo effect is, hereinafter, all about a belief in a deity (an imaginary being or idol) to whom believers turn to during their life’s trials and tribulations to make an appeal to the deity for help, or right after achieving their life’s goals to give thanks to the deity. Devout believers seem to turn to the deity regularly by ritually praying to and often invoking the deity for a guidance or help, or for thanking the deity for the blessings that they have in their life. But as mentioned before, the likelihood of a desired outcome or answering of a prayer would be 15% to 72% (as the sacred faith is also a placebo effect). Some believers even treat the deity as their imaginary friend or best friend forever (BFF); and as such, they often converse and share their secrets, fears, concerns, issues and/or wishes with the deity thereby building virtually not only a spiritual bond but also personal and even emotional relationship with their imaginary BFF (i.e., the deity). All these spiritual matters allude to a particularly important and undeniable fact that a sacred faith, regardless of which religion it belongs to is a purely personal spiritual matter; and hence, a sacred faith must always be protected and respected not only for a humanistic reason but also for a religious harmony in a society that is religiously diverse.

Since a sacred faith is innate, it may be surmised that a person may be coaxed or coerced to convert to a religion, but the person cannot be forced to really change the personal sacred faith right away unless a tremendous brainwashing through a persistent preaching or an emotional appeal with heart-felt stories has occurred. However, during the conversion, a unique spiritual/personal experience by the person may aid in the change of the personal sacred faith to a new sacred faith that is a belief in the God of the religion that the person converted to. In other words, it is much harder to coax or coerce someone to convert to another sacred faith than to another religion.

Therefore, a religion that is founded on a sacred faith (belief in God) may be differentiated from the sacred faith as faith is innate while religion is an ideology that comprises a doctrine, rituals, and teachings/injunctions which may be followed by the believers once they are told (and they believe) that the religious teachings/injunctions are Word of God if their sacred faith is firm. A religion that has positive, peaceful, and piety-oriented teachings/injunctions which also respect peoples of all other religions or of no religion seems to use its sacred faith positively to aid in establishing a pluralistic and tolerant society with a religious harmony. But if a religion that has divisive, supremacistic, hateful, violent teachings/injunctions which denigrate or disrespect peoples of all other religions or of no religion and enjoins its believers to sacrifice themselves or their property in a struggle to politically dominate the world seems to abuse the sacred faith of its believers while potentially causing a chaos or conflict in a society rendering it religiously disharmonious.

After objectively studying them in the light of modernity, certain teachings/injunctions of the religions of the monotheistic Abrahamic faith have been found to be understandably a product of their time; and as such, they seem to contravene the modern sciences and/or the modern moralities or ethics. For examples, a few of the teachings from the Bible are as follows:  Revelation 8:10: “And the third angel sounded, and there fell a great star from heaven, burning as it were a lamp, and it fell upon the third part of the rivers, and upon the fountains of waters;”; Ecclesiastes 1:5: “The sun also ariseth, and the sun goeth down, and hasteth to his place where he arose.”; 1 Kings 7:23: “And he made a molten sea, ten cubits from the one brim to the other: it was round all about, and his height was five cubits: and a line of thirty cubits did compass it round about.” And a few of the teachings from the Quran are as follows: Quran 18:86: “Till, when he reached the setting-place of the sun, he found it setting in a muddy spring, and found a people thereabout. We said: O Dhu’l-Qarneyn! Either punish or show them kindness.”; Quran 15:26: “We created man from sounding clay, from mud molded into shape”; Quran 86:6-7: He is created from a drop (semen) emitted- Proceeding from between the backbone and the ribs”; Quran 71:19: “And Allah has made the earth for you as a carpet (spread out)”; Quran 78:6-7: “Have We not made the earth as a wide expanse, And the mountains as pegs?” From an academic viewpoint, all these holy verses from the religious teachings must be read and understood in the historical context and time when they were “revealed” or written; and these holy verses must be revered and recited in their original language to keep the sacred faith safeguarded.

In summary, from an objective observer’s perspective, a faith (secular or sacred), which is found to be a placebo effect or innate—psychophysiological and psychoneuroimmunological, is must for a human survival or success as faith gives hope, learned optimism, and positive illusions; and as such, any personal faith is wonderful and must always be respected. On the other hand, a religion is an ideology which comprises a doctrine, rituals and teachings/injunctions that are a product of its history and antiquity and that may be, therefore, reinterpreted to be compatible with modern values.