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.
- Key Words Life-sustaining treatment
- clinical ethics
- end-of-life decision making
- national survey
ASJC Scopus subject areas
- Clinical Neurology
- Anesthesiology and Pain Medicine