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Doc's Moral Beliefs: Patient Dilemma?

Survey Finds 14% of Doctors Don't Feel Obliged to Present All Medical Options to Patients
By
WebMD Health News
Reviewed by Louise Chang, MD

The study is published in the Feb. 8 issue of The New England Journal of Medicine. It was done by University of Chicago doctors, including Farr Curlin, MD.

The researchers mailed surveys to 2,000 U.S. doctors, representing all medical specialties.

The surveys asked what a doctor's obligations are when a patient requests a legal medical procedure to which the doctor morally objects.

The vast majority -- 86% -- said physicians are obligated to present all the medical options to patients, regardless of their personal beliefs.

However, 8% disagreed, and 6% were undecided on the issue.

In addition, 63% said it would be ethical for morally conflicted doctors to "plainly" explain their moral objections to their patients.

And when asked if such conflicted doctors were obligated to refer patients to doctors without objections to the requested procedure, 29% either said "no" or were undecided.

Start Talking

"If physicians' ideas translate into their practices, then 14% of patients -- more than 40 million Americans -- may be cared for by physicians who do not believe they are obligated to disclose information about medically available treatments they consider objectionable," write Curlin and colleagues.

Curlin's team offers this advice to patients: Talk to your doctor about your views on thorny medical issues before a health emergency forces the discussion.

"Physicians and patients might engage in a respectful dialogue to anticipate areas of moral disagreement and to negotiate acceptable accommodations before crises develop," write Curlin and colleagues.

"Because patients and physicians come from many different moral traditions, religious and secular, they will sometimes disagree about whether a particular medical intervention is morally permissible," Curlin says in a University of Chicago news release.

Curlin is an assistant professor of medicine and a member of the university's MacLean Center for Clinical Medical Ethics.

About the Study

A total of 1,144 doctors completed the survey -- a bit less than two-thirds of those contacted.

They worked in specialties including family practice, pediatrics, internal medicine, psychiatry, surgery, and obstetrics and gynecology.

Here's a quick look at the group:

  • Nearly three-quarters were men.
  • Almost eight in 10 were white.
  • 90% said they attend religious services at least once per month.
  • About one-in-three noted religion as a key part of their lives.

When asked their religious affiliation, 60% said they were Christian, 16% said they were Jewish, 14% checked a box marked "other," and 10% checked a box marked "none."

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