U.S. Physicians' Opinions About Accommodating Religiously Based Requests for Continued Life-Sustaining Treatment

Area of Science:

• Medical Ethics
• Clinical Decision-Making
• Sociology of Religion

Background:

• Families of critically ill patients often request continued life-sustaining treatment (LST).
• Religious beliefs sometimes form the basis for these requests.
• Understanding physician responses to religiously motivated LST requests is crucial for ethical care.

Purpose of the Study:

• To investigate whether U.S. physicians are more inclined to honor LST continuation requests when religious reasons are provided.
• To differentiate the impact of religiously-based justifications versus faith-based expectations on physician decisions.

Main Methods:

• A 2010 survey of 1156 U.S. physicians from relevant specialties.
• Inclusion of two randomized experimental vignettes involving brain death and metastatic cancer scenarios.
• Experimental variation of family-stated reasons for LST continuation (religious requirement, hope for miracle, or no mention).

Main Results:

• Physicians were more likely to continue LST for a brain-dead patient when the family cited their Orthodox Jewish community (85% vs. 70%).
• For a metastatic cancer patient, physicians were more likely to continue LST when the son cited religious prohibition against discontinuation (65% vs. 46%).
• Requests based on expectation of divine healing did not significantly increase LST continuation rates.

Conclusions:

• Physician willingness to continue LST is influenced by religiously motivated requests, particularly those rooted in specific community or denominational traditions.
• Expectations of divine healing, unlike adherence to religious tenets, do not appear to significantly sway physician decisions on LST.
• These findings highlight the nuanced role of religious beliefs in end-of-life care decisions.