Physicians Face Ethical Conflicts With Religious Hospitals

Author: University of Chicago Medical Center
Published: 2010/04/09 - Updated: 2025/02/24
Publication Details: Peer-Reviewed, Research, Study, Analysis
Topic: Rehabilitation and Hospitals - Publications List

Page Content: Synopsis - Introduction - Main - Insights, Updates

Synopsis: Study reveals ethical conflicts faced by physicians in religious hospitals impacting patient care decisions in reproductive and end-of-life treatment.

Why it matters: This peer-reviewed study examines the ethical conflicts primary care physicians encounter when working within religiously affiliated hospitals. It reveals that nearly one in ten U.S. primary care doctors has faced situations where institutional religious policies clash with their clinical judgment, particularly concerning reproductive health and end-of-life care. The research highlights that younger and less religious physicians are more prone to these conflicts. Notably, while 96% of surveyed physicians believe they should adhere to hospital policies, 85% advocate for referring patients to alternative facilities when religious guidelines impede medical interventions. This information is crucial for patients, including those with disabilities and seniors, as it underscores the potential limitations in care options at religiously affiliated institutions and the importance of open doctor-patient communication regarding treatment availability - Disabled World (DW).

Introduction

Primary care physicians nationwide face clinical ethical conflicts with religious hospitals. Nearly one in ten primary care physicians in the United States has experienced a conflict with a religiously-affiliated hospital or practice over religious policies for patient care, researchers from the University of Chicago report in a paper published early online in the Journal of General Internal Medicine.

Main Item

Younger and less religious physicians are more likely to experience these conflicts than their older or more religious peers. Most primary care physicians feel that when clinical judgment conflicts with religious hospital policy, physicians should refer patients to another institution.

"Religious hospitals represent nearly 20 percent of our health care system," said study author Debra Stulberg, MD, instructor of family medicine and of obstetrics and gynecology at the University of Chicago. "Yet we know little about how religious policy affects the care doctors give to patients. This study is the first to systematically ask physicians whether religious hospital policies conflict with their judgment. We found that for a significant number of physicians, they do."

The study surveyed a representative sample of U.S. family physicians, general internists and general practitioners in 2007. Physicians were asked whether they had worked in a religiously-affiliated hospital or practice, if so, whether they had ever faced a conflict with the hospital or practice over religious policies for patient care, and what a physician ought to do if a patient should need a medical intervention and the hospital in which the physician works prohibits that intervention because of its religious affiliation.

Responses showed that 43 percent of primary care physicians have practiced in a religiously-affiliated setting. Of these, 19 percent experienced conflict with religious policies.

Ninety-six percent of all primary care physicians believe physicians should adhere to hospital policy. Eighty-five percent of physicians thought a doctor facing conflict with religious policies should refer the patient to another hospital. Ten percent endorsed recommending an alternate treatment that is not prohibited by the religious hospital.

"Primary care physicians routinely see patients facing reproductive health or end-of-life decisions that may be restricted in religious health care institutions, so we were not surprised to learn that nearly one in five of the physicians who have worked in a religious setting have faced a conflict with their hospital," Stulberg said.

The authors worried that it could be more difficult for physicians practicing in underserved communities to refer patients, when appropriate, to non-religious institutions, especially for time-sensitive but restricted interventions, such as emergency contraception. Whether such delays could be harmful, they note, "depends on one's beliefs about the intervention itself."

"We found that the physicians who work in religious hospitals and practices are a diverse group, from a wide range of religious and personal backgrounds," she added, "so hospitals sponsored by a specific religious denomination have providers who may not share their beliefs."

The Greenwall Foundation and the National Center for Complementary and Alternative Medicine funded this story. Additional authors include Ryan Lawrence and Farr Curlin of the University of Chicago and Jason Shattuck of Michigan State.

Insights, Analysis, and Developments

Catholic hospitals' religious rules impact care, especially for reproductive and end-of-life needs, affecting seniors and disabled patients in a big chunk of U.S. healthcare. It's hard to ignore the weight of Catholic hospitals in America's healthcare landscape - they're a lifeline for many, especially in underserved areas. But this article leaves you wondering: when religious doctrine steers medical decisions, who's really being served? Patients needing urgent care shouldn't have to navigate a moral maze just to get treated. For seniors and folks with disabilities, who often have fewer choices to begin with, these restrictions could hit even harder. The healthcare system's job is to heal, not to judge - and maybe it's time we ask whether faith-based limits are quietly chipping away at that promise

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by University of Chicago Medical Center and published on 2010/04/09, this content may have been edited for style, clarity, or brevity. For further details or clarifications, University of Chicago Medical Center can be contacted at uchicagomedicine.org NOTE: Disabled World does not provide any warranties or endorsements related to this article.