Do Doctors' Religious Beliefs Color Their Medical Decisions?

Does your doctor's religious beliefs color his decisions when it comes to palliative and elder care? Unfortunately, new research indicates that it does. According to a new study, "The role of doctors' religious faith and ethnicity in taking ethically controversial decisions during end-of-life care", published yesterday online in the Journal of Medical Ethics, doctors who are atheist or agnostic are "twice as likely" to make medical choices that can end a terminally ill patient's life more quickly.

In order to complete the study, which was conducted by Clive Seale, a professor of medical sociology at the Centre for Health Sciences in Barts and The London School of Medicine and Dentistry at Queen Mary University of London, researchers analyzed 4,000 surveys given to British physicians between 2007 and 2008 that questioned their end-of-life care and religious beliefs. Specifically, the doctors were asked about their religious beliefs and background, their position on assisted suicide, and were asked to describe their most recent experience regarding a patient who died under their care. The doctors surveyed were from many different practice groups including neurology, family medicine, geriatrics and hospice.

According to Seale, his findings showed that a doctor's religious beliefs undoubtedly influence the care the they provide for dying patients. For example, Seale found that "religious doctors are less likely to report having taken decisions which they expected or partly intended to shorten patients' lives, such as withdrawing life-sustaining treatments...[and] in the few times they do take such decisions, they are less likely to say they discussed this with the patient." Seale also found that those doctors who focused on geriatrics were more likely to identify as Hindu or Muslim, while those in palliative care were identify themselves as Christian. Additionally, Seale found that a physician's ethnicity may play a part in their end of care treatment of patients.

In addition to these findings, the study also found that:

1. British general practitioners are less likely to hold strong religious beliefs in general. This finding contrasts to research that indicates that American general practitioners more likely to be religious.

2. White physicians were the least likely to describe themselves as having strong religious beliefs and the most likely to support assisted suicide

3. Non-white and non-Asian physicians were more likely to oppose to assisted suicide

4. Doctors who described themselves as "very or extremely" non-religious were more likely to use sedation when treating dying patients, and twice as likely as religious doctors "to have been involved in decisions intended to hasten the end of life".

5. Doctors in hospital specialties were "10 times more likely to say they had been involved in a decision that was expected to hasten the end of life than palliative care physicians were".

The study's findings are actually quite surprising to me. I would have thought that doctors that were atheist or agnostic would actually try to lengthen their patient's lives as they typically do not believe in any sort of afterlife, while those doctors that were religious would tend to try and hasten their patient's lives if they were suffering. I personally believe that a doctor's religion and ethnic background should play no part in the type of care that they give, and that the only time that religion should be a consideration is when it is at the patient's request. I think that this study should serve as a wakeup call to doctors, both British and American, that their beliefs and background may be coloring their decisions and that they should alter their behavior accordingly. Doctors should be given more training to inform them of how their religion may be playing a part in their decisions, and trained to try and not let it dictate what care should be given to terminally-ill patients. Medical decisions should be made with the best interest of the patient in mind, and not by what makes the doctor most comfortable personally. If you would like to read all of Seale's findings that I may not have included in this blog, you can read his complete study at:

http://jme.bmj.com/content/early/2010/07/22/jme.2010.036194.full?sid=05d59dc1-3775-482f-aac0-0ded2b883d8b.
1 Comments
I agree, in an ideal world a doctor’s religious or ethnic background should not impact how they provide care – it should be up to the patient and his or her family. But, our backgrounds do inevitably influence how we approach things. Anyone providing health care should be trained in religio-cultural competence, so they learn both how their own and their patients’ religious beliefs and backgrounds influence decision-making, allowing them to provide the most effective care.
by Tanenbaum September 1, 2010 at 03:17 PM
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