Religion, Conscience, and Controversial Clinical Practices
Open accessAbstract
BACKGROUND: There is a heated debate about whether health professionals may refuse to provide treatments to which they object on moral grounds. It is important to understand how physicians think about their ethical rights and obligations when such conflicts emerge in clinical practice. METHODS: We conducted a cross-sectional survey of a stratified, random sample of 2000 practicing U.S. physicians from all specialties by mail. The primary criterion variables were physicians' judgments about their ethical rights and obligations when patients request a legal medical procedure to which the physician objects for religious or moral reasons. These procedures included administering terminal sedation in dying patients, providing abortion for failed contraception, and prescribing birth control to adolescents without parental approval. RESULTS: A total of 1144 of 1820 physicians (63%) responded to our survey. On the basis of our results, we estimate that most physicians believe that it is ethically permissible for doctors to explain their moral objections to patients (63%). Most also believe that physicians are obligated to present all options (86%) and to refer the patient to another clinician who does not object to the requested procedure (71%). Physicians who were male, those who were religious, and those who had personal objections to morally controversial clinical practices were less likely to report that doctors must disclose information about or refer patients for medical procedures to which the physician objected on moral grounds (multivariate odds ratios, 0.3 to 0.5). CONCLUSIONS: Many physicians do not consider themselves obligated to disclose information about or refer patients for legal but morally controversial medical procedures. Patients who want information about and access to such procedures may need to inquire proactively to determine whether their physicians would accommodate such requests.
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Most spiritual needs of medical and psychiatric patients currently go unmet.
“Studies of medical and psychiatric patients and those with terminal illnesses report that the vast majority have such needs, and most of those needs currently go unmet [579, 580].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [579]
The Discussion (page unavailable) concerns physicians’ willingness to disclose information about or refer patients for morally controversial treatments, not whether patients’ spiritual needs are met. Searches for spiritual needs among medical and psychiatric patients, including terminally ill patients, found no passage addressing that claim. (LLM, conf=0.75)
Experimental — accuracy not yet measuredStudies of medical and psychiatric patients and those with terminal illnesses report that the vast majority have spiritual needs related to medical or psychiatric illness.
“Studies of medical and psychiatric patients and those with terminal illnesses report that the vast majority have such needs, and most of those needs currently go unmet [579, 580].”
From Religion, Spirituality, and Health: The Research and Clinical Implications (2012) · cites this paper as [579]
The Methods and Questionnaire sections describe a survey of physicians about religious objections to controversial clinical practices, not studies of patients’ spiritual needs. A search for spiritual needs among medical, psychiatric, and terminally ill patients found no passage reporting that the vast majority have such needs. (LLM, conf=0.76)
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Self-citation
- Authors
- Curlin, F. A., Lawrence, R. E., Chin, M. H., & Lantos, J. D.
- Affiliations
- University of Chicago (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2007-02-08
- Volume
- 356
- Issue
- 6
- Pages
- 593-600
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC2867473
- OpenAlex
- W2116738317
- Cited by
- 397
- References
- 18
- Citations by year
- 2026: 7 · 2025: 9 · 2024: 11 · 2023: 52 · 2022: 5 · 2021: 11 · 2020: 19 · 2019: 17 · 2018: 15 · 2017: 20 · 2016: 18 · 2015: 15 · 2014: 16 · 2013: 30 · 2012: 20
- FWCI
- 34.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Greenwall Foundation (1 K23 AT002749)
- National Center for Complementary and Alternative Medicine
- National Center for Complementary and Integrative Health (K23AT002749)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical and Health Sciences Research
- Keywords
- physician refusal of treatment, physician ethical obligations, referral, palliative sedation, abortion, parental consent, physician attitudes, religion and medicine
- MeSH terms
- Abortion, Legal, Contraception, Cross-Sectional Studies, Ethics, Medical, Female, Humans, Male, Morals, Physicians, Surveys and Questionnaires, Religion and Medicine, United States, Refusal to Treat, Suicide, Assisted, Personal Autonomy, Bioethical Issues, Ethics, Clinical, Paternalism
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