Religion and Ethics in Healthcare

There are many scenarios where religion presents itself as a barrier or challenge to physicians when dealing with patients and the ethics of their situations. Religion plays an important role in a person's life, and that role is carried with the patient to hospitals or clinics. An individual’s religious beliefs can influence their mindset regarding their body, health, and physicians themselves.

For example, many Christians see God as the “Divine Physician” and may refuse medical treatment to an extent. Vaccines are refrained from, both for children and adults. Jehovah’s Witnesses also steer away from medications involving blood or blood transfusions. Mormons believe that drugs that contain alcohol or caffeine should be avoided, and Rastafarians believe similarly, with alcohol as a threat in their medication. Pain relievers are believed to be mind-altering by Buddhists, so the medicine is refused when a patient is dying. Additionally, religion can alter the way an individual connects illness with the world. Some Hawaiians form connections with the body, mind, and spirit regarding illness, and certain Native Americans may believe that a failure to harmonize with the environment causes disease.

However, despite a patient’s religion or beliefs, if a patient refuses medical care, understanding from the physician must be present and acceptable. There are ethical ways to approach this type of situation. According to the American Medical Association, physicians should be able to detect whether the patient’s refusal “compromises your commitment to his health,” fully understand the patient’s religious beliefs before acting, and respectfully prompt the patient to discuss necessary care and their refusal. In this way, the physician is able to analyze the setting accurately, and the proper decision can be made.

There have been many examples of patients who refused care due to religious reasons. A woman was in need of an examination of her bladder in the form of a cystoscopy. Although the risks of further development of the disease and the great chance of cancer were declared, the woman still refused due to her religion, which stated against intimate exposure. An interpreter was used to help close the language barrier between the physician and the patient, and efforts were made to help the woman absorb the seriousness of the situation. The conflict was based on the basic ethical guideline: respect for patient autonomy. This guideline is protected despite the danger she was in because of her refusal of the examination and desire to only receive pain relief. Published and long-standing laws are present to side with the patient’s right to refuse treatment. The woman’s refusal was also made possible because she was an adult and of sound mind. An unstable mental status of an adult does not permit the freedom to choose, and care cannot be refused. Cases involving children are far more complex, as situations can become escalated. In September of 2009, Dale and Shannon Hickman gave birth to a premature child in Oregon. The child died of pneumonia after 9 hours because medical care was not sought after, since the parents were members of the Followers of Christ and believed firmly in their “faith-healing rituals.” They ended up being charged with second-degree manslaughter. Children of older ages are also not able to make their own decisions regarding healthcare, which can lead to similar scenarios.

References:

Pilkington B. How your patients’ religious beliefs may influence their healthcare decisions [Internet]. MDLinx. 2021. Available from: https://www.mdlinx.com/article/how-your-patients-religious-beliefs-may-influence-their-healthcare-decisions/2e50tMh3fkxtswBJZ6di3Z 

Can People Refuse Medical Care Because Of Religious Beliefs? [Internet]. Doctorpedia. Available from: https://www.doctorpedia.com/channels/can-people-refuse-medical-care-because-of-religiousbeliefs/#:~:text=The%20law%20may%20vary%20by 

Smith T. Some patients believe God wants them to suffer. How to respond. [Internet]. American Medical Association. 2019. Available from: https://www.ama-assn.org/delivering-care/ethics/some-patients-believe-god-wants-them-suffer-how-respond 

English DC. Addressing a Patient’s Refusal of Care Based on Religious Beliefs. American Family Physician [Internet]. 2007 Nov 1;76(9):1393–4. Available from: https://www.aafp.org/pubs/afp/issues/2007/1101/p1393.html 

Religious and Spiritual Beliefs and Health Care | National Poll on Healthy Aging [Internet]. www.healthyagingpoll.org. 2022. Available from: https://www.healthyagingpoll.org/reports-more/report/religious-and-spiritual-beliefs-and-health-care