Undeclared belief on U.K. wards

Will your doctor's undeclared beliefs affect how you die?

Some proponents of assisted suicide legislation have suggested that a ‘conscience clause’ be included in any bill to allow doctors to agree to a person’s wish for aid in dying. And in Belgium, for instance, doctor who declines to perform euthanasia must transfer the patient’s medical file to a physician or person designated by the patient if requested to do so. Pharmacists in places where assisted suicide is lawful are also allowed to refuse to prescribe lethal drugs and doctors check that a phamacist is willing before referring a patient. There are many forms of help in dying, including ways that are legal in the UK. Terminal sedation and double effect allow for gradual increases of pain-killing drugs that have the secondary effect of shortening life. Where a person’s death will be hastened simply by refusing treatment, a living will effect a patient’s choice. Yet these are ‘soft’ cases. It is easy to assume that all doctors will act in more or less the same way within the law. But a new study suggests that end-of-life treatment decisions are  influenced to an extent by the doctor’s religious beliefs.

The study, published in the Journal of Medical Ethics, found that specialists in care of the elderly were somewhat more likely to be Hindu or Muslim than other doctors; palliative care specialists were somewhat more likely to be Christian, religious and ‘white’ than others. Doctors who described themselves as non-religious were more likely than others to report having given continuous deep sedation until death, having taken decisions they expected or partly intended to end life, and to have discussed these decisions with patients judged to have the capacity to participate in discussions.

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. Specialities 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.

The role of doctors’ religious faith and ethnicity in taking ethically controversial decisions during end-of-life care (JME 2010)
Physicians’ Religious Beliefs Influence End-of-Life Decisions (Medscape)
Doctors’ Religious Beliefs Strongly Influence End-of-Life Decisions (Science News)
Influence of physicians’ life stances on attitudes to end-of-life decisions and actual end-of-life decision-making in six countries (JME 2006)

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