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Autonomy, religion and clinical decisions: findings from a national physician survey.

Publication ,  Journal Article
Lawrence, RE; Curlin, FA
Published in: J Med Ethics
April 2009

BACKGROUND: Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors' decisions. Associations between physicians' religious characteristics and their weighting of the criteria were also examined. METHODS: Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. Physicians were asked how much weight should be given to the following: (1) the patient's expressed wishes and values, (2) the physician's own judgment about what is in the patient's best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. RESULTS: Response rate 51% (446/879). Half of physicians (55%) gave the patient's expressed wishes and values "the highest possible weight". In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient's expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the "highest possible weight", versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). CONCLUSIONS: Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians' decisions as much as is often recommended in the ethics literature.

Duke Scholars

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Published In

J Med Ethics

DOI

EISSN

1473-4257

Publication Date

April 2009

Volume

35

Issue

4

Start / End Page

214 / 218

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Statistics as Topic
  • Religion and Medicine
  • Practice Patterns, Physicians'
  • Physician-Patient Relations
  • Personal Autonomy
  • Patient Rights
  • Middle Aged
  • Male
  • Humans
 

Citation

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Lawrence, R. E., & Curlin, F. A. (2009). Autonomy, religion and clinical decisions: findings from a national physician survey. J Med Ethics, 35(4), 214–218. https://doi.org/10.1136/jme.2008.027565
Lawrence, R. E., and F. A. Curlin. “Autonomy, religion and clinical decisions: findings from a national physician survey.J Med Ethics 35, no. 4 (April 2009): 214–18. https://doi.org/10.1136/jme.2008.027565.
Lawrence RE, Curlin FA. Autonomy, religion and clinical decisions: findings from a national physician survey. J Med Ethics. 2009 Apr;35(4):214–8.
Lawrence, R. E., and F. A. Curlin. “Autonomy, religion and clinical decisions: findings from a national physician survey.J Med Ethics, vol. 35, no. 4, Apr. 2009, pp. 214–18. Pubmed, doi:10.1136/jme.2008.027565.
Lawrence RE, Curlin FA. Autonomy, religion and clinical decisions: findings from a national physician survey. J Med Ethics. 2009 Apr;35(4):214–218.

Published In

J Med Ethics

DOI

EISSN

1473-4257

Publication Date

April 2009

Volume

35

Issue

4

Start / End Page

214 / 218

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Statistics as Topic
  • Religion and Medicine
  • Practice Patterns, Physicians'
  • Physician-Patient Relations
  • Personal Autonomy
  • Patient Rights
  • Middle Aged
  • Male
  • Humans