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Studies reveal physicians' attitudes on end-of-life care

less willingness to cross that line into actually intending death," he added.

Kaldjian said the reasons for this attitude are open for discussion because the statistical study was descriptive, not designed to establish cause and effect.

The ACP study also showed that the more frequently a doctor attended religious services, the more likely he or she was to disagree with assisted suicide, as shown by these disagreement rates: 30 percent for non-attendees, 33 percent for less-than-monthly attendees, 52 percent for monthly attendees and 76 percent for weekly attendees.

"We found that the more frequently respondents attended religious services, there was a trend toward less support for assisted suicide but more support for terminal sedation," Kaldjian said. "To my knowledge, this is the first study to show such a stepwise trend."

The association with frequency of religious service attendance held true no matter what the religious affiliation of the physician.

Kaldjian said the studies collectively suggest that physicians do not separate their religious beliefs from decision-making in end-of-life care.

"We should not be surprised that physicians have religious beliefs and that, especially in some areas of medicine, these beliefs are operating in some way," he said. "A physician should not be seen as any less of a professional because of deeply-held religious convictions.

"Medical ethics involve not just a patient's autonomy but also a physician's integrity," he added. "On matters of such importance as end-of-life care, physicians' integrity must be respected. Patients should not see themselves as mere consumers of health care but as partners in a decision-making process with physicians, who are not mere robots."

The ACP-based study was funded in part by a dissertation fellowship to Kaldjian from the Graduate School at Yale University.


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Contact: Becky Soglin
becky-soglin@uiowa.edu
319-335-6660
University of Iowa
6-Dec-2004


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