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Doctors & Religion: When Faith and Medicine Clash

When a person’s faith conflicts with their doctor’s medical advice, the road to recovery may become more difficult to navigate but not impossible, a new study suggests.

Researchers found that when religion and medicine conflict, most doctors appear able to navigate the tension while keeping the patient’s well-being in mind.

Many patients use their religious beliefs and values to understand, cope and guide their personal health decisions, and these beliefs often conflict with their doctor’s recommendations. But researchers say it’s not clear how doctors negotiate these disagreements.

“There is often a tension between respecting the patient's religious beliefs and pursuing the patient's best interests," says researcher Farr Curlin, MD, assistant professor of medicine at the University of Chicago, in a news release. "We explored the ways doctors negotiate that tension, how they balance respect for a patient's beliefs against their own commitment to promote and protect a patient's health."

When Religion and Medicine Collide

In the study, researchers interviewed 21 doctors in order to explore how they handle conflicts between medicine and religion. Of the doctors interviewed, seven identified themselves as non-religious, six as Protestant, four as Jewish, two as Catholic, one as Hindu and one as Buddhist.

The results of the study appear in the Jan. 10 issue of Archives of Internal Medicine.

The study showed that nearly all of the doctors related examples in which their patients had used religious beliefs to characterize their disagreement with medical recommendations.

Overall, researchers found patients most often refuse medical recommendations for religious reasons in situations when the medical situation is unclear and the proposed treatment offers moderate possibilities of benefit or in situations in which treatment is intended to decrease risks in the future.

Doctors were most disturbed by cases in which the conflict was not between science and medicine but between “different worldviews,” such as patients or families who insisted that “life in any form was better than death” and demanded aggressive treatments against the doctor’s advice.

The study also showed that doctors were aggravated by patients who had no moral objection to a particular therapy but simply chose faith over medicine. Several doctors recalled cases in which there was an effective treatment but the patient chose to wait and rely on prayer instead.

But researchers found that if doctors believed their patient would suffer harm by not following their medical recommendations due to their religious beliefs, they would attempt to persuade the patient to reconsider his or her decision.

“Our findings suggest that physicians always navigate a balance between respect for patient autonomy (remaining open-minded and flexible) and concern for the patient’s good (persuading the patient to adhere to recommendations),” write Curlin and colleagues. “Rather than striving for illusory neutrality, physicians should practice an ethic of candid, respectful dialogue in which they negotiate accommodations that allow them to respectfully work together with patients, despite their different ways of understanding the world.”

By Jennifer Warner , reviewed by Brunilda Nazario, MD

SOURCES: Curlin, F. Archives of Internal Medicine, Jan. 10, 2005; vol 165: pp 88-91. News release, University of Chicago Medical Center.

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