Physicians face conflicts between faith and medicine

In the first study examining physicians' personal feelings about practicing medicine at religiously affiliated organizations, one in five primary-care physicians reported experiencing conflict over faith-based patient-care policies.

Led by Debra B. Stulberg, MD, and published in The Journal of General Internal Medicine, the study surveyed 446 family physicians and internists about how frequently they disagree with institutional policies in areas such as reproductive and end-of-life care.

Most of the physicians reporting conflicts worked in Catholic hospitals (which account for 12.5 percent of all U.S. community-based hospitals and 15.5 percent of hospital admissions), whose religious directives bar contraception, abortion and sterilization and, in many instances, rule out ending artificial hydration and nutrition.

When conflicts arise, 86 percent of surveyed physicians said they would recommend patients use another hospital, 10 percent said they would offer an alternative treatment that could be delivered at the religious hospital, and 4 percent endorsed violating the hospital's policy to provide the care.

"This is a very urgent problem and has been understudied," said Lois Uttley, director of the MergerWatch Project, which opposes healthcare organization mergers between Catholic and nonsectarian hospitals that result in reduced access to reproductive care services. "Until now, the balance of research and public policy in this country has focused on physicians and hospitals that want to refuse to provide certain health services because of their religious or moral beliefs," he told AM News. "What we haven't seen given proper attention is the ethical dilemma facing physicians who want to provide services because their patients need the services but who are unable to do so because of institutional religious restrictions."

In related news, the American Board of Anesthesiologists has decided to revoke the certification of any member who participates in executing a prisoner by lethal injection, reports the Washington Post. The decision raises the debate as to whether physician involvement is necessary to conduct humane executions and whether an anesthesiologist's role in an execution violates his or her oath to do no harm.

Although no doctors have been disciplined in connection to the rule thus far, physicians are taking the move seriously. "It sure will deter me. For the ABA to threaten to pull your board certification is a big deal," said one anesthesiologist who has consulted for prison officials in his state about drug dosages. None of those who criticized the policy--arguing that the decision should be left up to individual doctors' consciences--agreed to be named by the newspaper, saying they feared repercussions.

To learn more:
- read this American Medical Association article
- check out this TopNews piece
- read this National Center for Biotechnology abstract
- here's the Washington Post article

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