FRIDAY, May 5, 2006 (HealthDay News) -- While nine out of 10 doctors say it's fine to talk with patients about religion, a new study finds that only about half bring the subject up.
That's surprising because so many medical schools now make spiritual issues part of the curriculum, and because hospitals and nursing homes take "spiritual histories" of their patients, said Dr. Harold G. Koenig, director of the Center for the Study of Religion/Spirituality and Health at Duke University,
However, study author Dr. Farr A. Curlin was most surprised that one in five of the 1,144 doctors who took part in the survey said they pray with patients when asked, "one of the most controversial things in the medical literature," said Curlin, an assistant professor in the section of general internal medicine at the MacLean Center for Clinical Medical Ethics at the University of Chicago.
The study, in the May issue of Medical Care, reflects a omgoing debate about the need for spiritual discussions during medical treatment. The question is not about religious freedom or heavenly healing. Rather, it is about how religious principles shape patients' decisions about illness, care and death, and the role doctors should play in that struggle.
"The jury is still out," Curlin said. While religion is one way people cope with illness, the question is whether the nature of medicine sets some limits on how far a doctor should go, he said.
Some see a doctor's involvement as a necessary function of medicine, if only to determine what kind of care a patient will tolerate, he said. Others say a doctor's queries are an invasion of privacy.
But the differences in opinion are not just about professional boundaries, he said. People bring their own values to the subject, "and we have to know that if we are going to get anywhere."
The study found that 76 percent of doctors who identified themselves as highly religious were more likely to ask about a patient's beliefs, compared with 23 percent of less religious doctors.
Of the total, 39 percent said they were Protestants, 22 percent Catholic, 16 percent Jewish, 13 percent other, with the remainder reporting no religion. Protestants were more likely to raise the question of religion with patients.
However, the focus should not be on the patients' beliefs, Koenig said. Patients are frequently as uncomfortable with the subject as doctors are. But when it comes to matters of care such as psychotherapy, pregnancy, end-of-life and other issues, he believes a doctor needs to know what the patient wants and will accept.
"The only information the doctor should be getting is information related to the medical care of patients," he said. "The doctor is not there to make the patients more religious. The doctor needs to know of things that influence health."
"If half the doctors feel it is inappropriate to ask about these issues, that's like saying it's inappropriate to ask if patients smoke, their sexual preference and other factors we feel it is critical for the doctor to know about" in diagnosis and treatment, he said.
But praying with patients is a different and "far more aggressive" approach, he said.
Some patients value praying with a doctor, and will request it. A doctor may instead agree to be present when the patient prays, or ask to bring in a chaplain, he said. Studies have shown that patients who are at peace with their religious beliefs have better medical outcomes than those who are angry at God or face another spiritual conflict, he added.
The important thing, he said, is that "the patient has be the one in charge of this very sensitive area. But the doctor can't run away from it, either."
In fact, most don't, according to the study. While they are not the ones to initiate the conversation, more than 90 percent of the doctors said they believe it is appropriate to discuss religious or spiritual issues when a patient brings them up.
Seventy-three percent said that during the discussion they always encourage the patients' beliefs.
And 43 percent said it is inappropriate to talk about their own religious beliefs unless a patient asks.
More information
Visit the American Medical Association for its principles of medical ethics.
