Doctors’ beliefs influence end of life care

26 August 2010

DOCTORS who have no strong religious beliefs are almost twice as likely to help speed up the death of a very sick patient, according to new research.

The report in the Journal of Medical Ethics found doctors with a strong faith are less likely to discuss this type of treatment with a patient.

Almost 4000 UK doctors from a range of specialties responded to a survey asking what influence their religious belief – or lack of it – had on end of life care decisions. It found that religious beliefs did influence decisions taken by doctors caring for patients approaching the end of their life.

Postal questionnaires were completed by more than 1100 UK GPs, 311 palliative care specialists, 402 geriatricians, 190 neurologists and 1700 other hospital consultants.

Doctors were asked about their ethnicity and religious beliefs. Researchers then asked whether they supported the legalisation of assisted dying, whether they had ever provided continuous deep sedation until a patient’s death, whether they had knowingly taken a decision that had hastened the end of a patient’s life, and whether in taking that decision they had discussed it with the patient beforehand.

Of the GPs who responded, 14 per cent said they were very or extremely religious while 68 per cent said they were either not religious or only mildly so.

Compared to the group of palliative care specialists who responded, GPs were four times more likely to have taken a decision that they knew would hasten a patient’s death, and four times more likely to back a change in the law on assisted dying.

But irrespective of specialty, doctors who described themselves as “extremely” or “very non-religious” were almost twice as likely to report having taken these kinds of decisions as those with a religious belief.

The most religious doctors were significantly less likely to have discussed end of life care decisions with their patients than other doctors.

Professor Clive Seale, professor of medical sociology at Queen Mary University of London, concluded in the BMJ: “In multivariate analysis, being very or extremely non-religious increases the odds of a doctor reporting sedation or a decision with some intent to end life regardless of speciality.

He added: “Religion plays quite a big part in influencing what GPs think and do when they are dealing with end of life care decisions. You would expect that GPs respond to clinical factors but their own values come into play in quite a big way. If I were a patient approaching the end of my life, I would want a discussion about religious views with my GP.”