Physicians' Religious Beliefs Influence End-of-Life Decisions

August 26, 2010 — Physicians who describe themselves as nonreligious are almost twice as likely to make decisions that may end a patient's life compared with physicians who described themselves as religious, according to new research.
Clive Seale, PhD, from Barts and the London School of Medicine and Dentistry, in the United Kingdom, reported the findings online August 26 in the Journal of Medical Ethics.
"The relationship of UK doctors' religiosity and ethnicity to actual end-of-life decisions is poorly understood," noted Dr. Seale in his report. "The present study reports findings on these from a nationally representative survey of doctors, using methods that allow for comparison with censuses and surveys of the general UK population."
A total of 8857 UK medical practitioners were mailed an anonymous questionnaire to assess their end-of-life decisions for patients. Of those, 3733 (42.1%) responded, and 2923 reported on the care of a patient who had died. Specialties included were weighted for those in which end-of-life decisions are more common, such as neurology, elderly care, palliative care, intensive care, and general practice.
Physicians who described themselves as "extremely" or "very non-religious" were almost twice as likely to report having taken the kinds of decisions expected or partly intended to end life as were those with a religious belief.
Ethnicity was not related to rates of reporting ethically controversial decisions, although it was related to support for assisted dying/euthanasia legislation. Specialty was strongly related to whether a physician reported having taken decisions expected or partly intended to end life. Physicians in hospital specialties were almost 10 times as likely to report this as palliative care specialists.
The most religious physicians were also significantly less likely to have discussed end-of-life care decisions with their patients than other physicians.
Specialists in the care of the elderly were more likely to be Hindu or Muslim, whereas palliative care physicians were more likely than other physicians to be Christian and white and to state that they were "religious." Overall, white physicians, who were the largest ethnic group, were the least likely to report strong religious beliefs.
These attitudes were reflected in support for assisted dying/euthanasia legislation, with palliative care specialists and those with a strong faith more strongly opposed to euthanasia. Asian and white physicians were less opposed to such legislation than physicians from other ethnic groups.
"Whether religious or non-religious, it would seem advisable that doctors become more aware of how broader sets of values, such as those associated with religiosity or a non-religious outlook, may enter into their decision-making in end-of-life care," Dr. Seale concludes.
The study was supported by the National Council for Palliative Care. The author has disclosed no relevant financial relationships.
J Med Ethics. Published online August 26. 2010.