Docs' beliefs affect end-of-life care

If you think your beliefs are the only ones that affect your health care, pay attention to this: A doctor's own religious practice can become quite relevant to patient care, especially when end-of-life issues come into play.

A new study finds that doctors who are not religious are more likely to take steps to help end a very sick patient's life, and to discuss these kinds of decisions, than doctors who are very religious.

The study, published in the Journal of Medical Ethics, surveyed more than 8,500 doctors in the United Kingdom across a wide range of specialties such as neurology, palliative care, and general practice.

Researchers asked doctors about the last patient whom they had worked with who had died. The doctors answered questions about their own religious beliefs and ethnic background, as well as end of life care - did they give continuous deep sedation until death to the last patient who had died? Did they discuss decisions with the patient that would likely shorten the patient's life?

The study found that the strength of a doctor's religious faith is related to the incidence of continuous deep sedation until death, confirming findings of previous research. Researchers also found that a doctor who reported being "very or extremely non-religious" had an increased likelihood of taking these kinds of decisions to end a patient's life.

Doctors who said they were very religious were less willing to discuss decisions expected or partly intended to end life, the study found. This result corroborates what a 2007 New England Journal of Medicine study found: That more religious doctors are less likely to believe that they should give the patient information about procedures to which the doctors held moral objections.

Given that several studies have found similar patterns among religious and non-religious doctors, it's important for patients to find physicians who share their own values, said Paul Wolpe, bioethicist at Emory University, who was not involved in the study. But don't assume that just because a person comes from your ethnic background or faith that he or she shares all of your beliefs, he said.

It's important to have a health care surrogate who can make decisions for you in case you are in a critical health situation in which you can't speak for yourself, Wolpe said.

Is it a problem that doctors don't leave their religious beliefs at home? Some would argue yes, but Wolpe doesn't think so. The greater issue, he says, is finding a good fit between the desires and beliefs of patients their doctors.

"That’s more important than trying to achieve some unachievable ideal of all physicians behaving and believing the same way about controversial issues," he said.

What do you think? Share your thoughts in the comments.