Some Doctors Object to Discussing Controversial Care

Some alarming statistics based on a study recently published in the New England Journal of Medicine should lead to more awareness on the part of the public.

“If physicians’ ideas translate into their practices, then 14 percent of patients – more than 40 million Americans – may be cared for by physicians who do not believe they are obligated to disclose information about medically available treatments which they consider objectionable,” wrote Dr. Farr Curlin of the University of Chicago and his colleagues.

“In addition, 29 percent of patients — or nearly 100 million Americans — may be cared for by physicians who do not believe they have an obligation to refer the patient to another provider for such treatments.”

The study showed that men, Christian doctors and physicians with the strongest religious beliefs were most likely to say it is permissible to withhold information and not refer a patient to another source of controversial care.

The survey also found that a lot of doctors object to some forms of treatment. As stated by Curlin’s team, “For example, 52 percent of the physicians in this study reported objections to abortion for failed contraception, and 42 percent reported objections to contraception for adolescents without parental consent.”

They found that 86 percent of the doctors believed in presenting all options and 71 percent would refer patients to another doctor who does not object to the requested procedure.

The authors recommended that patients should ask their doctors outright about various options, since the survey showed that many doctors accommodate patients even when they have moral objections to certain situations. For example, of the 42 percent of respondents who reported objections to contraception for adolescents without parental consent, only 22 percent said physicians are not obligated to disclose all possible options to teenagers.

And regarding giving information to patients about terminal sedation, a practice that only 17 percent of the doctors found objectionable, only 11 percent of those doctors whose objections were based on moral reservations said doctors can withhold information.

“When we train doctors we encourage them to try to be ethical, and to practice ethically they must first make judgments in any situation about what is good for the patient,” Curlin said.

“They also have to have the will to do what they judge to be good. And in our culture, where there are so many possible uses of medical technology, people will disagree at times on what is permissible.”