U.S. Physicians' Opinions About Accommodating Religiously Based Requests for Continued Life-Sustaining Treatment.

CONTEXT: Families of critically ill patients occasionally request that physicians continue life-sustaining treatment (LST), sometimes giving religious reasons. OBJECTIVES: To examine whether U.S. physicians are more likely to accommodate requests for LST that are based on religious reasons. METHODS: In 2010, we surveyed 1156 practicing U.S. physicians from specialties likely to care for adult patients with advanced illness. The questionnaire included two randomized experimental vignettes: one where a family asked that LST be continued for a patient that met brain death criteria and a second where the son of an elderly patient with cancer insists on continuing LST. In both, we experimentally varied the reasons that the family member gave to justify the request, to see if physicians are more likely to accommodate a request based on a religious requirement or hope for a miracle, compared to no mention of either. For physicians' religious characteristics, we assessed their religious affiliation and level of religiosity. RESULTS: For the patient meeting brain death criteria, physicians were more likely to accommodate the request to continue LST when the family mentioned their Orthodox Jewish community (85% vs. 70%, P < 0.001). For the patient with metastatic cancer, physicians were more likely to accommodate the request when the son said his religious faith does not permit discontinuing LST (65% vs. 46%, P < 0.001), but not when he said he expected divine healing (50% vs. 46%). CONCLUSION: Physicians appear more willing to accommodate requests to continue LST when those requests are based on particular religious communities or traditions, but not when based on expectations of divine healing.

Duke Scholars

Author Farr A Curlin Medicine, Geriatrics and Palliative Care