Physicians’ Beliefs About Conscience in Medicine: A National Survey

Abstract

Purpose To explore physicians’ beliefs about whether physicians sometimes have a professional obligation to provide medical services even if doing so goes against their conscience, and to examine associations between physicians’ opinions and their religious and ethical commitments. Method A survey was mailed in 2007 to a stratified random sample of 1,000 U.S. primary care physicians, selected from the American Medical Association Physician Masterfile. Participants were classified into three groups according to agreement or disagreement with two statements: “A physician should never do what he or she believes is morally wrong, no matter what experts say,” and “Sometimes physicians have a professional ethical obligation to provide medical services even if they personally believe it would be morally wrong to do so.” Results The response rate was 51% (446/879 delivered questionnaires). Forty-two percent and 22% believed they are never and sometimes, respectively, obligated to do what they personally believe is wrong, and 36% agreed with both statements. Physicians who are more religious are more likely to believe that physicians are never obligated to do what they believe is wrong (58% and 31% of those with high and low intrinsic religiosity, respectively; multivariate odds ratio, 2.9; 95% CI, 1.2–7.2). Those with moral objections to any of three controversial practices were more likely to hold that physicians should never do what they believe is wrong. Conclusion A substantial minority of physicians do not believe there is ever a professional obligation to do something they personally believe is wrong.

The Impact of Neonatologists' Religiosity and Spirituality on Health Care Delivery for High-Risk Neonates

“…However, for a small group (7%) of neonatologists, there is no obligation to refer parents to a provider who would offer an option to which they object; another 9% of neonatologists were uncertain about a physicians' moral obligation to refer parents at the border of viability. These percentages are similar to those reported by Lawrence et al 11 among primary care physicians but lower than those reported by Curlin et al 1 where 18% of U.S. physicians reported no moral obligation and 11% were uncertain of the obligation to refer a patient to a provider that is willing to perform a procedure or provide treatment that the physician believes is morally wrong. A similar percentage of religious, spiritual, and neither religious nor spiritual neonatologists in our study support conscientious refusal.…”

Religious Hospitals and Primary Care Physicians: Conflicts over Policies for Patient Care

“…Survey questions and responses used to characterize physician religiosity reflect those used in related research. 9,22,26,27 The failure to see directional trends where they might be predicted (for example, we might have expected more frequent attendance at religious services to be associated with a lower odds of conflict with religious hospital policies than infrequent attendance) may be due to chance given the small sample size for sub-group analysis. However, this failure may call into question the usefulness of these results.…”

Predictors of hospitalised patients' preferences for physician-directed medical decision-making

“…While Levinson et al surveyed adults in the general population, and Joffe et al surveyed recently discharged patients, this study surveyed medicine inpatients admitted to a large urban medical centre. This is an important patient population because healthy people cannot always predict what their preferences will be when they fall ill. We considered demographic characteristics, religious characteristics and patient health status as possible predictors, since all have been found to be relevant to debates over the role of patient autonomy in the medical decision-making process 2 4 6 7…”