Comments on: Doctor’s Faith and End of Life Decisions

By: eean

eean — Tue, 31 Aug 2010 17:21:08 +0000

@SchreiberBike: I also haven’t read the study, but given that its peer-reviewed and specialty was something that was analyzed, I’m sure they would’ve tested whether the religion effect had significance independent of specialty.

I mean we did that sort of thing in my college ANOVA class, so I don’t see why not.

By: iqguy001

iqguy001 — Mon, 30 Aug 2010 00:34:09 +0000

“In this survey 8,000 doctors were contacted, and less than four thousand responded. That right there is a massive self-selection factor that renders any results of this survey preliminary at best.”

Assuming the initial selection of targets for the survey was sufficiently random, anything over a 20% response rate is typically accepted as a statistically valid sample. A 50% response rate is really quite a good response rate.

But I agree with your overall conclusion that the reporting of this survey is backwards.

By: SchreiberBike

SchreiberBike — Sun, 29 Aug 2010 15:17:20 +0000

I only have access to the abstract, but based on the data I can see, I would suspect that any relationship between “doctors religious faith” and “decisions during end-of-life care” is secondary to “specialty.” It seems very likely that the causal relationship is specialty of the practitioner.

Perhaps doctors who spend more time with dying patients and who work in the more technical/scientific side of medicine are more likely to be atheists. That experience and background would likely have a large effect on both “religious faith” and “decisions during end-of-life care.” The driving factor is probably not faith but specialty.

By: Skeptocyclist

Skeptocyclist — Sat, 28 Aug 2010 12:34:03 +0000

It’s not my experience that palliative care specialists are more likely to push continued treatment. The current New England Journal of Medicine has a study about terminal cancer patients being randomly assigned to a group getting cancer treatment and a group getting cancer treatment plus palliative care. The palliative care group was more likely to discontinue futile treatment, reported higher satisfaction, and, counter-intuitively, lived an average of 3 months longer than the group getting cancer treatment alone. Palliative care focuses on relieving symptoms and engaging the patient in a discussion of their treatment goals. Perhaps the difference in the study is that the treatment docs would still rather prescribe a medicine that could shorten life than actually talk with the patient. I’m glad to hear that you Steve do have those difficult conversations.

By: HHC

HHC — Sat, 28 Aug 2010 05:42:28 +0000

Death is the natural endpoint for terminal illness. The patient’s body shuts down and refuses to respond to science’s best efforts. Sedation is useful for psychiatric purposes, but like all medicines in the end remains useless. Living wills are a way to deal with the ending ethically. Its not legally sound to ask an incompetent, severely depressed/ suicidal patient or gravely disabled patient to make a decision. So if the family and patient has left their decision-making until an extreme crisis occurs, planning for a dignified ending is not possible. Medicine’s partner in society is the law.

By: ltbear

ltbear — Sat, 28 Aug 2010 01:57:06 +0000

but but but… those doctors are Lying for Jesus™!

By: CivilUnrest

CivilUnrest — Fri, 27 Aug 2010 19:50:04 +0000

PS:

Here’s some unbiased reporting of this study:

“Religious Doctors Less Likely to Kill Patients With Euthanasia”
http://www.lifenews.com/bio3153.html

By: CivilUnrest

CivilUnrest — Fri, 27 Aug 2010 19:49:04 +0000

Any doctor who is treating a terminally ill patient and is unwilling to discuss end-of-life options is taking a pretty cowardly way out. One of the most difficult things to do is to admit that, despite your best efforts, there’s nothing useful that can be done.

You’d think that religious folk would be more comfortable with the idea that some things are out of their hands (seeing as how they believe that there is some super-power controlling everything).

By: stompsfrogs

stompsfrogs — Fri, 27 Aug 2010 18:19:40 +0000

Conclusions Greater acknowledgement of the relationship of doctors’ ~~values~~ specialty with clinical decision-making is advocated.

fixed.

By: kris

kris — Fri, 27 Aug 2010 17:16:05 +0000

Nice post. I was hoping you’d blog on this.