Doctors' Moral Views Influence Their Advice to Patients

WEDNESDAY, Feb. 7 (HealthDay News) -- Your physician's moral outlook may play a larger role in your medical care than you realize, according to the first-ever survey of doctors' views on controversial procedures.

For example, more than half (52 percent) of doctors surveyed objected to the use of abortion due to failed contraception, and about 40 percent said they wouldn't give a 16-year-old a contraceptive without parental consent.

What's more, nearly one-third (29 percent) of physicians interviewed said they would balk at referring a patient to another doctor for a procedure or drug they felt qualms about recommending themselves.

And 14 percent -- one in seven -- said they would not mention a procedure they believed to be morally wrong as a viable treatment option.

However, that stance is itself "morally questionable," contends one medical ethicist, Dr. David Stern, an associate professor of medicine and medical education at the University of Michigan.

No one is advocating that doctors perform procedures they object to, Stern said. However, "because we are in a position of power over patients who walk through the door, I think we have a professional responsibility to at least disclose treatments," said Stern, who was not involved in the study.

The findings, by a team from the University of Chicago, are published in the Feb. 8 issue of theNew England Journal of Medicine.

The physician's office has always been "ground zero" for controversial medical issues such as euthanasia, abortion, and contraceptives such as the "morning-after pill." However, up until this survey, experts have known little about what U.S. doctors think about sensitive issues like these, and how those views might impact medical practice.

The new study was led by Dr. Farr Curlin, an associate professor of medicine at the University of Chicago's MacLean Center for Clinical Medical Ethics. His team surveyed 1,144 physicians from varying specialities on their views on issues such as abortion, giving terminal sedation to dying patients, and prescribing birth control to teens without their parents' consent.

The doctors were also quizzed about their level of religious belief and its importance in their lives.

The results: 83 percent of physicians said they had no objection to terminal sedation of the dying, and 48 percent said they had no moral objection to abortion in the case of failed contraception. Fifty-eight percent of doctors had no problem prescribing contraception to a minor without parental consent.

Most doctors (63 percent) also felt that it was "ethically permissible" to express a personal moral bias to a patient. The large majority -- 86 percent -- agreed that, even if a doctor objected to a particular legal medical procedure, he or she was still obligated to list it as an available treatment option when advising patients.