First, Do No Evangelizing

By Richard P. Sloan Should the medical care you receive from your doctor depend upon the quality of the available … Continued

By Richard P. Sloan

Should the medical care you receive from your doctor depend upon the quality of the available treatments? Or should it depend upon the doctor’s religious beliefs or political ideology? These are questions we should ask in light of Surgeon General nominee Dr. James Holsinger’s recent appearance before the Senate and because, as a country, we have become infatuated with the idea that religious devotion is good for our health. The conflicting loyalties of personal faith and professional responsibility portend danger for patients.

Most of us believe that childhood vaccination programs not only are good for individual children but promote the wellbeing of the entire country. What should we do about doctors who won’t administer the vaccines for chickenpox, hepatitis, measles, polio, and rabies because they believe that they derive from aborted fetal tissue? Recently, the Wisconsin legislature considered a bill allowing a doctor to refuse not only to administer the chickenpox vaccine to a child but also to refuse to inform the child’s parents about it by claiming religious opposition. Such objection holds the wellbeing of the larger society hostage to the moral views of a small minority by risking the resurgence of epidemic diseases we conquered decades ago.

This conflict between religious belief and medical science, it appears, is not uncommon, making it all the more dangerous. Recently, the New England Journal of Medicine reported that 14% of U.S. physicians, representing different regions of the country and different medical specialties, believe that their personal religious views rather than the needs of their patients should determine which perfectly legal medical treatments they offer and, more distressing still, that they are under no particular obligation to disclose this bias to their patients or to refer them to other physicians who will offer the treatment. Ethicists have noted that because doctors have state licenses giving them exclusive rights to practice medicine, they have an obligation to deliver medical care to all those who seek it, not just to those who share their religious convictions. That means understanding the best scientific evidence about which factors contribute to health and which ones don’t and practicing medicine accordingly. It means not permitting personal values, religious or otherwise, to supersede the best interests of patients.

In addition to influencing the availability of medical procedures, religious intrusion into medical practice threatens to violate the norm of patient autonomy by manipulative or even coercive means. Already, the Christian Medical and Dental Association, a professional society with more than 17,000 members, publishes a handbook that instructs physicians on how to use their practices to evangelize. According to a recent article in the Des Moines Register, the Iowa City VA Hospital repeatedly attempted to convert a Jewish veteran to Christianity during hospitalizations over the past two year. In 2004, CBS News reported on a Colorado orthopedic surgeon who “requests” that patients pray with him while they are gowned and supine on the gurney, ready to be wheeled into surgery. Because medical patients very often are in pain and fearful, they are especially vulnerable to manipulation by physicians who, even in these days of medical consumerism, retain positions of authority in the physician-patient relationship. When doctors capitalize on this authority to pursue a religious rather than a medical agenda, they violate ethical standards of patient care.

No one disputes that for a great many people, religion provides comfort in times of difficulty, whether illness related or otherwise. But being a medical professional means assuming certain responsibilities and foremost among them is acting in the interests of your patients rather than allowing your personal religious beliefs to interfere. As epidemiologist Petr Skrabanek put it years ago, to allow doctors’ religious values to interfere with the care patients receive is “a social movement dressed up in scientific language.” For doctors who can’t do this, there is a clear alternative: find another profession.

Richard P. Sloan is Professor of Behavioral Medical at Columbia University Medical Center and the New York State Psychiatric Institute and author of “Blind Faith: The Unholy Alliance of Religion and Medicine.”

  • Al

    Aren’t we forgetting freedom of religion here? I would personally be more comforted if I knew my doctor was of strong faith. I do realize that not everyone agrees with me, but that is their own choice. Since we all have the freedom to pick our own doctors, I believe there is a better alternative than the one you suggested: Find another doctor.

  • yoyo

    Prof SloanI believe you are absolutely correct,

  • Anonymous

    If religion had its way doctors would be witch doctors,and prayer and ritual would be science.

  • Anon

    It seems that most people who want doctors to impose their religious beliefs on their patients, are Christians, probably of the predominant Baptist and Catholic denominations. When the patient and the doctor are of the same beliefs, there may not be problems. I wonder how these people would handle having a doctor of a different faith, e.g. Jehovah’s Witness (no blood transfusions) or Buddhist (no surgery). How many people would feel comfortable with their surgeon praying over them to a different god, right before surgery? Changing doctors is not as easy as some would portray with HMOs, and most doctors do not advertise their religions.

  • BR

    To AL:You’re missing the point.Also, finding another doctor is not always easy with some insurance companies and/or remote locations. And there is no rule or law stating a doctor must reveal a political or religious bias in his or her practice, so a patient would have no way of knowing that his or her treatment has been limited by the beliefs of the doctor.

  • Nellie

    Long ago, Science and spirituality used to be one discipline, Science and religion separated so that Christians would not have to murder Scientists for heresy and Scientists could continue studying the world without fear of losing their lives(most of the time.)Science and medicine have the ability to change. They can take in new information and make the necessary adjustments to grow with society, not against it. If I lived in first century BC, I would probably have liked the christen view; it would be closer to Christ’s original message and have been appropriate to the time and the place. Since then all the interesting and useful parts of it have been burned and killed off, it’s a stranger to the original. It has degenerated into a mental debilitation that keeps its members small, phobic, and unable to ever manifest their god given potential. When Women used herbs to heal their family and neighbors (the first pharmacies), Christians first demonized and then burned them for it. Christians because of the nature of their religion can’t grow or change and it means that they’re still willing to light the match anyway they can, I think devout doctoring is that match.

  • DF in FL

    Here we go, mixing religion and science again. So, how are we to know if a doctor neglects to mention optional treatments because the treatment conflicts with the physician’s personal religious beliefs?Do religious physicians charge less than non-religious physicians? Do they live in smaller homes and drive less expensive automobiles?How are we to know whether a physician really is a religious person or they simply claiming to be religious in order to attract religious patients?Will religious physicians begin to include their religion in their advertising?If patients can choose physicians based on the physician’s religion, should physicians “choose” patients according to theirs? Will the typical forms that we fill out on our first visit to a physician begin to include a box for “religion”?Mixing religion and healthcare is incredibly dangerous to everyone involved. History has proven that to us over and over again.

  • Nellie

    Correction.I meant AD of course,not BC.

  • mcbrideka

    it’s pretty remarkable that anyone in a position with as much responsibility as a physician would think that they could make decisions for others based upon personal beliefs.While these scenarios may all seem absurd – and rest assured they are – it doesn’t mean that they don’t/can’t happen.We rely on professional public servants to do the jobs that they have accepted.if someone was to accept a job as a cook at burger king and on the first day said “ooo. ya know.. i’m a vegan. i can’t prepare anything with meat, or animal products. i can’t even touch it.” would you expect them to keep thier job?it should go without saying for an occupation that when you accept the responsibility you need to uphold it, or work elsewhere.the medical profession is our course endlessly more complex than the restaurant industry, and therefore more care should be taken to ensure that doctors are first and foremost caring for their patients – based on the patients needs, not the doctors spiritual ones.

  • Carl Feher

    It’s the same old same old; introducing religion into a situation ends up causing more of a problems than helping . I want my medical care religion free thank you very much. My God definitely has different opinions than your God so let’s just keep both of them out of our medical conversation shall we?

  • John

    This reminds me of a similar and even more troubling phenomenon – fundamentalist Christians in the Pentagon and our military who do not accept the fact that the US was not founded as a Christian nation and who often believe in an immanent second-coming, i.e. Armaggedon.

  • lepidopteryx

    DF: Good point. Unless the patient has a medical education, how would he know that his doctor was withholding information? Patients have a right to know ALL available options for treatment, not just the ones the doctor approves of.**Will religious physicians begin to include their religion in their advertising?**Some actually do. AFA even has a list of Christian medical and dental associations on a sidebar of their news page. **If patients can choose physicians based on the physician’s religion, should physicians “choose” patients according to theirs? Will the typical forms that we fill out on our first visit to a physician begin to include a box for “religion”?**Hmmm. Most hospital forms do have a blank for religion – I always assumed that it was so that they could provide you with a chaplain of your own faith if you requested one, or bring in someone to perform the rituals appropriate to your faith if you should die. Often those blanks are multiple choice: Catholic, Protestant, Jewish, Muslim, None, or Other.

  • sam

    Saying a doctor can hide treatment options from you is like saying it’s ok if the builder who builds your house changes the blueprints without your permission because he feels it’s a better Idea. If doctors don’t want to provide non emergency treatment because they have ethical considerations fine. But that doesn’t give them the right to hide the options from thier patients. It’s simple if they hide treatment options they should have thier license removed. Really where does this end. What happens when a scientologist becomes a doctor or some quack from a fringe group becomes a doctor and starts pushing thier wild and crazy beliefs. In spite of the impassioned defense by reasonable persons if it is allowed where is the line. At what point does it become religion and what point does it become medical mal practice because valid treatment options where never discussed.

  • sam

    Saying a doctor can hide treatment options from you is like saying it’s ok if the builder who builds your house changes the blueprints without your permission because he feels it’s a better Idea. If doctors don’t want to provide non emergency treatment because they have ethical considerations fine. But that doesn’t give them the right to hide the options from thier patients. It’s simple if they hide treatment options they should have thier license removed. Really where does this end. What happens when a scientologist becomes a doctor or some quack from a fringe group becomes a doctor and starts pushing thier wild and crazy beliefs. In spite of the impassioned defense by reasonable persons if it is allowed where is the line. At what point does it become religion and what point does it become medical mal practice because valid treatment options were never discussed.

  • sam

    Saying a doctor can hide treatment options from you is like saying it’s ok if the builder who builds your house changes the blueprints without your permission because he feels it’s a better Idea. If doctors don’t want to provide non emergency treatment because they have ethical considerations fine. But that doesn’t give them the right to hide the options from thier patients. It’s simple if they hide treatment options they should have thier license removed. Really where does this end. What happens when a scientologist becomes a doctor or some quack from a fringe group becomes a doctor and starts pushing thier wild and crazy beliefs. In spite of the impassioned defense by reasonable persons if it is allowed where is the line. At what point does it become religion and what point does it become medical mal practice because valid treatment options were never discussed.

  • Some Idiot

    I agree wholeheartedly with MCBRIDEKA. Whatever happened to keeping your spiritual beliefs private or expecting them to be so respected that a clear conflict of interest can’t be adequately addressed? I think that the food industry was a great point of comparison. When I was in college I dated a girl who was a very strict vegan but she was a waitress at a local restaurant that served meat. Had she refused handle meat she would have been summarily fired for failing to do her job correctly and there would be nothing wrong with that. It has never ceased to amaze me that people who do this, be it physicians or pharmacists, aren’t simply fired for failing to perform their duties. Why is that so wrong?I also take exception with “Anon”‘s characterization of Catholics as the types who would only want to go to a Catholic doctor. My family is Catholic and growing up our doctor was a Jew. No one ever had any problems with this because he was a good doctor and knew his business and did not hesitate to discuss all medical options regardless of wether or not they were controversial.I think that a large part of the problem is that our society has confused discussing the facts or acknowledging some practice exists with giving it a moral endorsement. Live and let live and learn to keep your religious views where they should be, private.

  • mcbride

    Doc:I don’t think anyone would object to your treating the poor and indigent, working long hours or providing treatment for free – regardless of your motivations.where people object to christianity interceding with the medical profession is where the physician’s faith results in a lack of treatment, obscuring of treatment options or refusal to refer the patient to a doctor who will treat them.

  • Jim

    Doctors are approaching a category similar to that of lawyers and politicians, avaricious predators. Try not paying one of these holy rollers and see how soon God’s teachings are forgotten. END THE REPUBLICAN WAR IN IRAQ.

  • Jim

    Doctors are approaching a category similar to that of lawyers and politicians, avaricious predators. Try not paying one of these holy rollers and see how soon God’s teachings are forgotten. END THE REPUBLICAN WAR IN IRAQ.

  • Tara

    I couldn’t agree more with Dr. Sloan. It’s frightening how many individuals in the health care profession feel it’s acceptable to NOT PERFORM their job duties due to religious beliefs. Pharmacists who refuse to dispense birth control are another example. I once turned down a professional position (in the medical field) because I would have had an ethical difficulty with some of the situations I would encounter. And that’s how it should be handled. I didn’t expect them to mold the job to my beliefs. I do not want to be preached to as I’m going into surgery, and I want to have the confidence that any medical professional I encounter is going to have my best interests at heart and is going to use whatever approved treatment is most appropriate and effective, regardless of their own beliefs. Religious beliefs can be an important guiding force in one’s life, but not at the expense of doing one’s job well. If this poses a dilemma, you’re in the wrong field. The old saying, “If you can’t take the heat, get out of the kitchen”, certainly applies here.

  • kathyn

    DOC, do you disclose your religious position (I am a christian first and a physician second) to your patients and explain the ramifications of that to them, so they can select another doctor if they choose? If that is the case and I cam to you as a patient, I would hear you out and ask for a referral to another physician. No harm, no foul.However, if I was your patient and needed treatment, and only then found out that you put your religious principles first, I would be placed in a vulnerable position without my consent. That, in my opinion would be unconscionable.As fo the doctor who wants patients on the way to surgery to pray with him or her, that is abusive. The patient at that point could certainly not “find another doctor” as a previous poster suggested. In that situation I would be angry, not the right state in which to enter surgery, but might feel forced to comply for fear that my doctor would consider me a heathen not worthy of the best care.

  • Grashnak

    Interesting that when the “doc” in question is Christian and exercising his right to refuse to perform a legal procedure, some people seem to think that is okay. I’m curious how Doc would feel if one of his family members expired in the emergency room because the Jehovah’s Witness doctor didn’t believe in blood transfusions…Everyone is fine with people exercising their right to religious expression, when the religion being expressed is the same as theirs of course…

  • jaded

    The problem extends beyond physicians to other medical professionals like pharmacists and nurse practitioners — e.g. you’re given a prescription for birth control but your neighborhood pharmacy won’t fill it because Jesus wouldn’t approve (and Joe Pharmacist is a Christian first and a pharmacist second). If you’re in a city you’d walk a few blocks to the next pharmacy but in small town USA there may only be one game in town, so to speak…

  • Daniel

    This is not really about mixing religon and medicine, and it is not really about mixing Christianity and religion; it is about mixing right-wing-born-again-Christian-evangelicalism wih medicine. Except for these Christian poseurs, there is no problem. I don’t think anyone would want to compel a physician to perform an abortion, if he does not do abortions. But, most other medical procedures or prescriptions, mainly having to do with sex, specifically birth control and impotence, should be carried out according to the wishes of the patient, in accordance with good science and accepted medical practice; and doctors who have a religouss problem with this might seek psychiatric counseling for an obvious relgious mania, and also perhaps, give up their medical practice.

  • Michael Crist

    Amen,this is a slippery slope down to ignorance and a return to the image of shamen and witch doctors. Freedom of religion also means freedom from having religion pushed on you. In the past 200 – 250 fifty years medicine has moved from a system of beliefs (remember night vapors)to a scientific model. I do not want a doctor to preach to me and I do not want a preacher operating on me. I grant a medical professional the right to believe the way he or she wants to, but do not think they have the right to withhold the best medical care available because of it. I also think that doing so amounts to a criminal activity and should be severely punished.

  • jhbyer

    Thanks, Mr. Sloan, for saying so well what needs to be said to those whose faith is not just blind but deaf to reason, such that only the law prevents their cruel trespass on patients’ rights.

  • Daniel

    The problem is not Christians; it is Jesus-maniacs; there is a difference. To make a long story short, some people do not have an ounce of sense.

  • Terrence Jones MD

    As a practicing physician I must denounce my colleagues that are engaging in “faith based descrimination.” I find such behavior is fundamentally no different than other forms of bigotry that are widely recognized as unacceptable in our society. Although bowing to thiestic prejudice may be considered a plus in the church, it has no place in medicine. The patients welfare must come first, and if practitioners are unable to accept this, then perhaps a career in the clergy would be more appropriate. Bigotry masquerading as piety is offensive, and differs little from the practice of “islamacists” that twist thier own religious texts in an attempt to justify the inexcusable. When such bigotry is used to deny patients medical care and treatments it approaches the criminal, and should be grounds for license revocation.

  • MWS

    In the early ’80′s my sister-in-law went to her gynecologist for her yearly exam. In the 12 months since her last exam, her doctor had “found Jesus.” After the exam, he refused to prescribe birth control pills as it was against his religious beliefs. He also refused to help with severe cramping problems and PMS. He advised her to pray and read the Bible for these. For a doctor, I believe, at bare minimum, this borders on negligence. My personal opinion is he had no right to do this. But the least he could have done was consult with her prior to her exam, explaining his new found belief and giving her the option to walk right then and there. If a doctor’s religion comes first, then the minimum he/she should do is inform the patient, explain that there might be other remedies the he will not use or consult with the patient on due this belief. I cannot understand how the so-called Christians believe in the sanctity of life for unborn fetus, but the sanctity of life for living, breathing human beings not so much.I ended up making her an appointment with my gynecologist, who promptly changed her BC pills to a different dosage, which solved the cramping problem as well and prescribed something else for the PMS, which corrected that.

  • khote

    Until we see and recognize religious and other magical faiths for the mental illness they are, and treat them as such, we will never be free of the kind of nonsense which premises the question.Never. You can have faith in that.

  • HML

    I respect the right for everyone to believe what they want. I also respect the right for doctors to refuse to perform services that go against their religous beliefs provided: I know that it is incredibly difficult to separate religion from our daily lives. And honestly, I don’t care what my doctors believe as long as it doesn’t impact my care or my right to choose my care. I think the point that Sloan is trying to make is that doctors who keep information from their patients because of their own personal beliefs are playing with not only their patients’ lives but also those of people around them.

  • Joe

    So those who refuse to abort children should not be permitted to become doctors?

  • Steve H.

    Doc, I’m a Christian, too. But when Jesus healed the lame, the blind, lepers, etc., he didn’t ask whether the sick person was devout–he saw their need and addressed it. Period!NO health-care professional has the right to withhold treatment or prevention options from patients, much less coerce them into adopting your religion. If you don’t feel comfortable prescribing contraceptives, for example, then at least have the decency to refer your patient to someone who will put the patient first.If you can’t live up to that basic obligation, then perhaps you’re in the wrong business.

  • AMviennaVA

    Daniel: Exactly. I am fed up with the way the right wing has appropriated the term ‘Christian’ for the preferences; and how willing their opponents are to perpetuate it.

  • Joe

    So those who refuse to abort children should not be permitted to become doctors? I would contend that those who do perform abortions are a blight to the profession.

  • khote

    those who refuse to perform abortions should have no more right to force their religious taint on others, any more than those who do perform abortions should be allowed to perform them on the unwilling.You religious types are just not going to get it, you’re not going to understand it. your agenda is too thick, the fog too deep. why can’t you just play in your own playground and leave the real world to those who actually live in it?

  • lepidopteryx

    Joe:Those who refuse to perform an abortion can certainly become doctors, but perhaps podiatry might be a better specialty for them than OB/GYN.

  • ESL

    DOC,It would be nice of you to post, if not your name, at least your city of origin, so that patients in your area might know to be on the look out for you and have some means of avoiding you. I would NEVER go to you as a patient. You place your religious beliefs above the personal health of your patients. If it were me, and you didn’t disclose your ethical and religious approach to health care, I would feel poorly, if not malevolently served.

  • Noah

    Doc, as many have said, it is perfectly fine to choose to be a Christian first and a doctor second. But you should have the obligation to disclose that fact to me. You should have to inform me that your religious beliefs will not permit you to perform certain taks. You should also have to inform me if, upon me contracting a disease or needing treatment, about treatment options you would not be willing to perform.It is perfectly fine for a doctor to not wish to perform certain treatment options. It is abhorrent to hide those treatment options from your patients.

  • CP

    If it is allowed for Christian doctors to impose their religious beliefs on their patients, then it should be perfectly okay to allow the Muslim Cab Drivers to refuse Cab service to passengers who are carrying some kind of alchohol.It offends their religious beliefs to be a carrier of alchohol, just as it is offensive for a Christian doctor to perform an abortion. Both are providing a service to the public. But Christian doctors and pharmacists are allowed to do as they wish but poor Muslims have no right to protest and if they do their licenses are revoked.

  • AMviennaVA

    khote @ August 9, 2007 2:24 PM: I have posted it before: ‘Abortion’ is an elective procedure. There is no obligation by anyone to acquiesce to every single request that is made.Or were you referring to cases where the physical existence of the mother is at stake?

  • WILLEM

    RELIGION IS THE PROBLEM AND NOT THE ANSWER!!

  • Fiona HV

    Bottom line, if your religious convictions mean that you cannot provide the full spectrum of services and treatment that your job entails, then it’s time to quit and get a job were your religious convictions won’t interfere.

  • Maureen

    If I had a doctor trying to force his religious beliefs down my throat and refusing to give me medical care based on his/her religious beliefs, I would run out of his/her office immediately. If I was in a hospital, even in a hospital gown, I would run out of there so fast it would make your head swim.What a disgrace! This country was not founded on peoples’ religious beliefs and to mix someone’s religious beliefs with their profession is absolutely apalling.It’s like this hyper-nut pharmacists refusing to fill prescriptions for the morning after pill or birth control. If that ever happened to me, I would start legal proceedings against the pharmacist and against the corporation he or she worked for.We must put a stop to these religious nut cases before they TOTALLY ruin this country. They’ve already made a start doing that with the revered President Moron Bush.

  • Anonymous

    “Joe asks: As it’s only possible to abort feotus’s, not children, then the question is moot.

  • MaryD

    Forty five years ago I was refused the pill by a Catholic doctor. He said he was doing this for religious reasons. I quit going to this doctor. That’s the solution to the problem.

  • MaryD

    Forty five years ago I was refused the pill by a Catholic doctor. He said he was doing this for religious reasons. I quit going to this doctor. That’s the solution to the problem.

  • Fiona HV

    “Joe asks: As it’s only possible to abort feotus’s, not children, then the question is moot.

  • MaryD

    Forty five years ago I was refused the pill by a Catholic doctor. He said he was doing this for religious reasons. I quit going to this doctor. That’s the solution to the problem.

  • MaryD

    Forty five years ago I was refused the pill by a Catholic doctor. He said he was doing this for religious reasons. I quit going to this doctor. That’s the solution to the problem.

  • Sarah

    I’m a Catholic & don’t care what faith my doctor practices. If she should suggest a treatment that I feel to be incompatible with my beliefs I can reject it. It’s my right as the patient to make that decision; the physician shouldn’t make it for me.

  • PriveR

    On this:”In 2004, CBS News reported on a Colorado orthopedic surgeon who “requests” that patients pray with him while they are gowned and supine on the gurney, ready to be wheeled into surgery.”I would love to see the look on that doctor’s face if the person being operated on happened to be a Pagan, turned to him and said “ok doc- point my gurney towards North first, then East in a clockwise direction” and then begins to call the corners.

  • New Paradigm for Health

    Things I need to remind myself of when seeing a doctor.I must revoke my assumption that my doctor will give me the best care possible.I no longer have the right to all the information I need to make an informed choice.I should be prepared to fight for my life or bring a friend to help if I’m too weak or confused. Because choices about my medical health are not mine to make; my Dr might make bad decisions for me without my knowledge based on his/her religion. I can’t trust the medical profession so I need to wise up and get infomed.

  • Louise Hanson

    I found the article about religion and medical care most interesting. On this topic, I experienced a most unsettling experience when I visited an ear specialist in my town of Lawrence, KS last week. While in the examining room before the consultation, the nurse came into the room with a form that gave me two options: to have the doctor pray with me (yes or no). I checked “no,” and the doctor did not invite a prayer opportunity. Nonetheless, I was put off by the episode. Am I to think that the doctor surmises I am not a cooperative patient, or that I don’t won’t to do everything possible (including asking God’s help) to be well, or ????

  • also a doc

    Sixty years ago when antibiotics first came out, many people believed that giving antibiotics was setting up doctors to play God. God was the proper authority to decide if a patient lived or died, not some doctor with a syringe. And the scientific evidence was so obvious: during pneumonia the patient had a “crisis”, the peak in the battle between the bacteria and the body’s fight against it, at which time the patient either died or rather suddenly began to recover – making divine intervention a pretty tempting explanation for the sudden turnaround.Today the vast majority of us accept antibiotics as either a scientific boon or a divine gift (depending on your personal beliefs), and it would be considered criminal for a physician to withhold antibiotics when death was possibly without them.So, is this ethical relativism at work (changing ethics to suit the current situation), or an appreciation that maybe leaving everything up to divine intervention is just plain silly when humans were given (or posess) the intellect to discover antibiotics for themselves? I am faced with ethical challenges constantly as a physician. Personally, I think it is criminal for a physician to fail to inform a patient about a medical option even if that physician will not carry it out themselves. As a person of faith I find religion gives me comfort and another forum in which to seek discernment, but the difference between right and wrong is not the exclusive property of Jesus Christ, Allah, Budda or any other deity. Human physicians are engaged in a dance between slipping into ethical relativism vs compassion for suffering that could be alleviated with technology; those whose heads are filled with their own self-righteousness cannot even hear the music. And what does this mean for people like Al who don’t seem to realize that a patient is in no position to make an educated decision if the doctor withholds the information from him that he needs to make the decision. Its one thing to announce to a pregnant woman on the first prenatal visit “if you are bleeding to death and require an emergent abortion I will allow you to bleed to death, so if you don’t like that find another doctor”, its another altogether to fail to mention it until the husband asks why his wife is dead.

  • KRISTY

    Dr. Sloan’s article describes more of a lack of good judgment than it does a conflict between faith and professional responsibility.A doctor who believes that vaccinations are made from aborted babies is horribly ill-informed and I would be concerned to have him treat my child for anything. In such a situation, it would be the doctor’s duty to inform parents (who hopefully already know about vaccinations) of their availability and refer them to another doctor. It is definitely far-fetched to think that, based on a single anecdote of an ill-informed doctor, we should fear a resurgence of infectious diseases. Doctors should not be forced to provide abortions, but they should also have the common decency to not coerce their pre-surgical patients into praying with them. If the surgeon wants to pray, that’s fine, but bed-side evangelism is potentially uncomfortable for the patient as well as unlikely to lead to the religious conversion evangelism seeks.I am a Christian, but I realize that the topic of religion raises a lot of emotions in people, and in many cases, it is very personal. Although I don’t agree that I need to keep my faith to myself, I hope that people will recognize my faith because of my actions and not because I accosted someone who didn’t really want to hear about it. I am confounded, however, by the hostility of some of the posts. Personal attacks such as “you religious types” and referring to faith as a mental illness are belligerent and unhelpful. So are assumptions that the only medical procedure a doctor of faith would object to is abortion. Just two examples are that devout Muslim males might have issues with treating women and Jehovah’s Witnesses might have issues with performing blood transfusions. As Steve H stated, if doctors refuse to perform a procedure, they at least need to provide a referral to their patients or in an emergency situation, find another doctor to perform the procedure.

  • Michael

    For all the folks who have some problems along the line of “So, how are we to know if a doctor neglects to mention optional treatments because the treatment conflicts with the physician’s personal religious beliefs?”OK, let’s *all* take a moment to calm down.Feeling better yet? If not, consider taking another moment before proceeding.Ready? OK. Seriously now, imagine someone else (not you or your family) has some medical condition that has nothing to do with sex, abortion, religion, hysteria, or anything else. Let’s not mix more issues than we need to here. If you can’t imagine anything, call the condition a cold if nothing else, but make it a particularly bad one where no one knows if it might be fatal. Also imagine a doctor, again not anyone you know or know about, just a nice generic but well trained physician.Still with me so far? Good. So, our imaginary patient with the imaginary disease goes to see our imaginary doctor. Based on the question at hand, do you want:A) The imaginary patient does not want the doctor to neglect any optional treatments, whether they conflict with the doctor’s belief or not.I could be wrong, but I don’t think most folks really want option A when they really think about it. Most any condition has so many potential treatments that the patient will most likely die before even all of the “scientific” medical options could be exhausted, not to mention how the condition could be treated across all time and space. Could be entertaining, I suppose (leeches, anyone? I’ve seen these other treatments on the internet…), but that’s not why most folks go to their doctor. Most people seem to post that they would like option B, but most people really seem to want to hear what the doctor thinks is best—robbing the doctor of their personal beliefs removes the ability of that doctor to use judgment and what they know about the patient to formulate which treatment options would be best for that individual. I’m not hearing anyone at present arguing for option C, although in times past this was thought to be best for the patient and society, and exhibit A would be the Hippocratic Oath to support that argument. Option D seems to really be what most folks want, despite themselves. People really do want their physician to use judgment, and that will include by definition the religious beliefs of the physician. It should also include everything else listed too, which includes the religious beliefs of the patient. Logically, then, the physician may find options that rise to that short list of “best options” to be presented that may violate the religious beliefs of either the physician or the patient—they should be presented as options either way. When faced with a patient who has religious objections to blood transfusions, abortion, or anything else, I still present those options to give the patient the opportunity to reject them, and continue to work with the patient to find options that will work for them in light of all the other considerations. When patients decide that they want options that I can’t provide them, whether for my personal religious beliefs or any of the other considerations listed in option D, I explain why I can’t provide that service and do what I can to assist them in obtaining what they want when possible. Sometimes, it’s not possible to do that. I had a drug-addicted patient requesting morphine once, and politely declined to assist them with treating their addiction with an endless supply of narcotics because of my beliefs (which, incidentally, included religious, ethical, and scientific considerations). I did offer to refer them to a drug treatment facility among a few other options, but my offers were less politely declined. It is also worth noting that sometimes my beliefs serve the patient above other considerations. Before Plan B was available over the counter, prescriptions had to be written, but not all insurance plans would cover it. Personal beliefs, including religious beliefs, that a 14 year old incest victim should have access to Plan B trumped considerations over (in this particular case) insurance and financial considerations to find creative means to obtain it for her when she and her family decided that would be the best option for her. Had I not had access to my religious beliefs, she never would have received Plan B because of reasons that had nothing to do with her or my religious beliefs, but other considerations out of both of our control. Certainly, personal religious beliefs of the physician can make the doctor-patient relationship dysfunctional, but likewise they can enrich it far beyond what would be possible without those beliefs.Or, as my momma always said, “Don’t throw out the baby with the bathwater.”

  • James Buchanan

    Keep your personal beliefs out of your professional behavior, or you are no longer a professional. End of story.Pray for your own damned forgiveness, don’t tell me how to live.

  • sully

    MaryD wrote: “Forty five years ago I was refused the pill by a Catholic doctor. He said he was doing this for religious reasons. I quit going to this doctor. That’s the solution to the problem.”That’s one solution, but what happens when you are unconscious and bleeding on the gurney and the Christian Scientist doctor decides not to give you a blood transfusion because it conflicts with his beliefs? Or decides, without telling you, that you should not get a treatment that might cause some future pregnancy to terminate early but might make your life better? Making decisions on what doctor to use when you can make an informed decision is of course a good thing. Its when you cannot make an informed decision that it is a problem. “DO No Harm” is a relative term for some people of religion. It may not refer to the patient as one poster noted above concerning aborting “children”. When you’re in a car accident and 3 months pregnant and you uterus is crushed and you need a historectomy to prevent bleeding to death, which of course means aborting the fetus, ask yourself whether doctors should be allowed to practice if they can make decisions decided FOR THEM by a church or non-medical group and your benefit is a secondary consideration. Hipocrites was right, do no harm. He never mentioned religious convictions or even the law. Its been a good policy for doctors for eons. Leave it to the evangelical christians and many muslims to decide its not good.

  • Patrick

    Pharmicts believed the same as this small group of doctors. these Pharmacists were wrong, just as these doctors are wrong. If you want someone to pray with you, invite them to your church or your home, but not in your office, that I am paying for by using their services.Perhaps doctors are more hypacrite than we know today. Perhaps the AMA should withhold their credentials until they stop thinking they know what is better for everyone else except themselves.Perhaps doctors should actually practice medicine instead of George Bush’s version of science.

  • TJFRMLA

    MARYD:You are an enabler. What if you in a small town and the “catholic” doctor is the only one on your medical plan? A doctor’s religous belief must NEVER be a factor in treating a patient. If the license to practice medicine is granted by the State, ANY durg or procedure that is also licensed by the State must be made available by that doctor. If their religion means so much…please pick another profession. (Maybe you can light the candles at church or mow the grass…) I’m sooooo sick of people thinking it’s OK to impose their religious crap on the public. It’s yours…no one else wants to hear about it or deal with it. I’m sueing the first holy-roller doctor that brings that crap to my bedside. I pay for my mrdical insurance and I won’t put up with it.

  • AMviennaVA

    James Buchanan: You posted “Keep your personal beliefs out of your professional behavior, or you are no longer a professional. End of story.Pray for your own damned forgiveness, don’t tell me how to live.”Aren’t you in turn telling everyone else how to live?

  • Mary

    What a surprise that most of the comments are anti-religion. Every time there is an article about faith, you can count on the majority writing in to say “keep your faith off me.” But let’s leave faith out of this and just harken back to the original Hippocratic Oath that doctors used to adhere to. Only in the past century have “respectable” doctors argued that abortions and use of aborted fetal tissue are medically Ok, and do not violate the Hippocratic Oath of “first, do no harm.” Go ahead and call the unborn a “fetus” if it makes you feel better. Any doctor practicing knows that a fetus is both a living human being, AND that “fetus” is the Latin term for “child.” Even today, most respectable doctors don’t perform abortions, or won’t discuss that they do at a cocktail party, because it is still, even after 33 years of Roe v. Wade, seen as at least “distasteful” or kind of ugly.It is the medical profession that has changed in the last 30+ years to accept the use of unborn children to benefit those who are born. Those doctors who still adhere to respecting all human life are the REAL traditional scientists, and American public opinion is now swinging back in their direction. I personally would rather see a doctor who respected human life, than one who is dismissive about it, arrogant and treats some human lives as merely utilitarian.

  • Paganplace

    One of the biggest problems with this is where evangelical Christian doctors get government to say they don’t even have to tell their patients the *truth* about what procedures they won’t perform, …this is essentially legalized malpractice.Doctors essentially are given a license to represent *science,* and people do tend to believe in that authority: real doctors, of course, aren’t like the brilliant characters in medical drama, but the image and authority persists. Patients are supposed to trust them not to hold things back because they don’t approve of you. It goes beyond the evangelical Christian obsession with controlling sex and reproduction: it goes to patient treatment on all levels. Professional ethics and standards are there to *prevent* patients from falling victim to malpractice or abuse that a doctor’s personal beliefs might find perfectly reasonable, even mandatory: the simple fact of these religious positions is: It’s not a medical professional’s *job.* If they want special excuses, they must be up front about it, (informed consent) and not put themselves in positions where they may be tempted to put their own beliefs over the rights and needs of patients. Period.

  • Harry

    This is a freightening trend. The religious rights always want to dictate other’s lives. They suck.

  • also a doc

    Patrick, the AMA does not credential doctors. It is a voluntary lobbying organization and I know few fellow physicians of my generation who belong to it.Michael, you are quite skilled in the false dichotomy game. Karl Rove has an internship waiting for you. No one has implied that the morality of requiring a physician to consider all treatment options means the physician stops using his or her medical judgement. Just because I think those who railed against antibiotics 50 years ago were mistaken in their moral logic, it does not mean I would prescribe antibiotics for a viral infection (where they would do no good and might do harm) simply because the patinet asked for a prescription. Here is the fallacy behind refusal to prescribe birth control: A niece of mine had severe endometriosis and birth control pills were her last option before a hysterectomy. She was young, not currently dating, and had not yet had children but hoped to some day. Further, her kidneys were being damaged by the huge doses of ibuprofen she was taking for the pain every month. Mercifully, the pills worked, and her fertility and renal function are protected. In what moral world would it be a pharmacist’s (or the physician’s) decision to deprive her of her medical options to be free from pain while protecting her future fertility and her kidneys? In what moral world is it the pharmacist’s business to know why those pills are prescribed for her?The self-righteousness of a pharmacist or physician who would deprive her of a medical option is the true un-Christian morality.

  • Anonymous

    also a doc wrote..”but the difference between right and wrong is not the exclusive property of Jesus Christ, Allah, Budda or any other deity.”The Buddha is not a diety. is in order before revealing your ignorance of anothers faith and belief system. The Buddha was a real man, proven to live prior to Jesus in India. India studies Sidartha/Shakyamuni in an historical context, not in the context of a diety.Christians constantly reveal their lack of Buddhist knowledge through comparisons of christianity and buddhism, but constantly share uninformed opinions about Buddhism. I studied Christianity before I comment about christinaity. Perhaps chtristians might consider the same approach.Buuddhist practice’s are just as varied as chrisitan practices. STUDY before making opinions!

  • lepidopteryx

    PriveR: “In 2004, CBS News reported on a Colorado orthopedic surgeon who “requests” that patients pray with him while they are gowned and supine on the gurney, ready to be wheeled into surgery.”I would love to see the look on that doctor’s face if the person being operated on happened to be a Pagan, turned to him and said “ok doc- point my gurney towards North first, then East in a clockwise direction” and then begins to call the corners.**Now I have to clean green tea off my monitor! I can just picture that doctor asking my husband to pray with him, and my husband saying “Sure,” then clapping three times and beginning to chant in Japanese.

  • Michael

    Like others, I’m disturbed by DOC’s statement that he is a Christian first and a doctor second. But I am also not surprised. From the point of view of the true believer, DOC’s statement is exactly correct. One’s religious faith must, as part of that faith, be paramount. It must inform and define that person’s life, and all that that person does, including how their discharge their obligations to the state, their job obligations, their family obligations, etc. That’s fine from DOC’s point of view. From his religious perspective, he self-righteously villifies the morals of those who think abortions should be performed by doctors. Again, from a religious point of view, his statements are entirely consistent. Which, I guess, is the whole point of Dr. Sloan’s article. Those who do NOT subscribe to DOC’s priorities (no matter how fervently held those priorities might be) should not be forced to adopt his priorities simply because they have consulted him for medical advice. Anyone is free to consult a priest, a pastor, a rabbi, for religious counsel on what medical procedures they should or should not avail themselves of. When one consults a doctor, however, they do not consult them for their religious counsel. They consult them for unfettered medical advice. It may be alright from DOC’s point of view to force his religious beliefs and priorities on his patients — it may even be mandated by his religion. But that’s a problem from the patient’s point of view, who wants and is entitled to sound medical advice, untainted by religious prioritization.

  • Anonymous

    Christian Scientist doctor? Are you kidding?

  • also a doc

    anonymousfar be it from me to offend you. If you are unable or unwilling to consider my post in context rather than as individual words, then please consider my post corrected to read: “but the difference between right and wrong is not the exclusive property of any one particular religion”

  • Henry E

    May I remind everyone that the Medical procedures that were “practiced” in Germany and German occupied Europe between say 1935 and 1945 were actually legal, and also required to be performed!And yes, I will equate those practices with some of the practices that have shown up in parts of Europe and the US.

  • Nelly

    So the only Doctor on call in an emergency room allows a patient (a stranger) to die, who could have survived, because the Doctor refused to perform a procedure that goes against Christian beliefs. Are there no legal repercussions for this? Can the doctor be sued? Will he/she at least lose his/her license? Are medical associations OK with these kinds of deaths? Have there already been preventable deaths? Who would know? Are there any studies measuring this? Who is condoning it? Who is fighting it?If they don’t at least lose their license what prevents this from happening to me or anyone I care about? I really never thought I’d see this day when my personal well being would not be protected by a doctor. I could become collateral damage to someone’s personal crusade. I’m not OK with that. I’m not taking this loss of personal security very well at all.

  • Daniel

    Michael had a long hypothetical discussion. I would file all that “stuff” he wrote under “would’a could’a should’a;” or alternatively, under “yadda-yadda-yadda.”We don’t have to be hypothetical, when the specific cases are few. As I said earlier, I do not think there is an issue with compelling physicians to perform abortions if they do not do them. Doesn’t that just go without saying? Many doctors do not do abortions; that sounds reasonable.In real life, people run into problems with birth control and “erectile dysfunction” as it is now called. Anything to do with human sexuality can be a touchy topic for conservative fundamentalist people of all types. We know that this sort of ultra-conservative prudishness is really more about a person’s psychological problems with human sexuality, than with religion. Maybe such people shouldn’t even be doctors.Specifically, some health care workers may not “approve” of birth control, period. Others may not approve of it for unmarried people. The same goes for viagra and other impotence drugs. The problem with these people being doctors is that there is something weirdly wrong going on inside their heads, that they feel called upon to comment on and even supervise the sex lives of other people, when it is just plain old common sense to let people alone in these matters.

  • cynic

    And now they are asking us to PRAY for the victims of the bridge collapse in Minneapolis and the trapped miners in Utah. Where will it end?

  • TEL

    Mary:You seem to believe that doctors know best. As a scientist with a Ph.D in microbiology, I have found many doctors to be woefully uninformed time and again. And someone who puts their religion before their ability to practice medicine is much less likely to stay informed on actual facts, and continue believing imaginary ones. Like this silly discussion about fetal tissue and vaccinations. Fetal tissue isn’t used to make vaccines that I’m aware of. It may surprise you to find this out, but most tissue cultures weren’t derived from fetuses. Is an evangelical doctor going to research the issue him/herself, or to accept what has been told to them by their church.? If their religion comes first, I’m guessing they’ll go with what their church tells them. A competent doctor, no matter what their belief, would inform themselves.For me, I really don’t care what my doctor’s religious beliefs are, anymore than he/she should care about mine. The real issue we should be discussing is competentcy.

  • Michael (er, the other Michael)

    Daniel,”We don’t have to be hypothetical, when the specific cases are few.” Actually, the whole point of my “yadda-yadda-yadda” is that there are not just a few specific cases. I deal with this every single day, and there are far more cases than the few specific ones you choose to see. I mentioned two in my post, but could easily mention many, many more. The fact that you seem to see only the ones that dwell on human sexuality seems to indicate “something weirdly wrong going on” in your head rather than those of us that include religious beliefs when seeing patients to try to find the best possible solutions for their total health care. Like I said before, try looking at the issue *after* you take the sex part out, and see what it looks like then.

  • PriveR

    Lepi:”Now I have to clean green tea off my monitor!Oops. LOL. I couldn’t resist. :)I can just picture that doctor asking my husband to pray with him, and my husband saying “Sure,” then clapping three times and beginning to chant in Japanese. “That would certainly be something to see! It sounds lovely, btw. If I may ask, is it Shinto?

  • lepidopteryx

    PRIVER:”If I may ask, is it Shinto?”No, Sukyo Mahikari.

  • also a doc

    No DOC, its not a straw man. The pharmacists who refuse to fill birth control prescriptions at all, or refuse to fill them for a woman without a wedding ring, know nothing about the women they refuse, even if the pills are used for endometriosis. And they have no God-given right to be privy to the medical information on why the pills were prescribed so they can decide of they think its justified to make an “exception”. Yes, birth control is a charged example, but the right of the patient to confidential medical treatment applies to both charged and uncharged situations.You also refer to the Catholic principle of “double effect” – if a pregnant woman is dying and saving her life means ending the pregnancy, the bad outcome of the second effect (ending the pregnancy) is outweighed by the primary intent which is to save life. So with endometriosis, if the pills are prescribed for endometriosis and not birth control, the fact that they have a second (double) effect of preventing pregnancy does not overrule their use. So if a doctor prescribes them, is it up to the pharmacist to check up on the doctor why they were used?Following double effect out, think about where it goes. If a child might die from chicken pox (and children on chemo, with AIDS, and all other kind of immune deficits can very well die from chicken pox), can they be vaccinated even though the vaccine has a second effect of being made by a process the physician thinks immoral? DOes the physician have a right to fail to inform parents that a vaccine is available, even when the vaccine might save their child’s life, or more likely the life of a child exposed to their child’s chicken pox?Now think about stem cells. If the primary effect is intended to save life, and the secondary effect is that the treatment uses embryos that were going to be discarded anyway, does using the treatment violate the principile of double effect?

  • TJFRMLA

    DOCPlease tell me you have a sign on your door that states your position onn abortion. I for one, would like to know ahead of making an appointment that there were services and procedures I could not get from a particular doctor. When are patients informed of giving the shopping list of your services?

  • Ben

    I must respectfully disgree with the authors conclusions.I frequently hear the repose that professionals, in whatever line of work, should “Set aside” their religious beliefs.However easy this might seem to persons with no, or weak faith, the very idea of religious convictions means they are not something which can be lightly – if at all – set aside. That is a concept which I gather is rather difficult for persons who lack a strong religious conviction to grasp.We live in a free democratic society. Are you going to require all businesses to offer services which they disagree with? Are you going to require a book seller to carry pornographic magazines, or if not to advise all patrons that they are not carrying them and where they can be found?I personally disagre with doctors who choose not to offer vaccines based on the possibility they were devloped using fetal tissue. I think the initial research was immoral, but that should not prevent a valid medical technique from being used.But I do not think doctors should be required to offer services or treatments which they find morally objectionable. That is their choice.It seems you would have anyone subjugate their own moral values to those of whomever seeks their services, or even yourself. Why not require all doctors to perform abortions if their patients request them? After all they are legal – if reprehensible.If assisted suicide were legal in a jurisdiction, would all doctors within that jurisdiction be required to perform that act if requested by their patient.If patients do not like the services offered by their doctor – THEY ARE FREE TO SEEK ANOTHER DOCTOR!! It’s about time we put just a tiny bit of responsibility back where it belongs – on the individual.

  • Michael (the evil fantasy one)

    Wow. Who thought I’d piss off everyone by asking for reason and balance…Doc, you said: “Knock it off. This is about abortion, not my priorities or my beliefs supposedly interfering with someone’s health.” Er, what was the question on hand? Here I was thinking that the question was regarding should a doctors beliefs impact patient care, but apparently I walked into the abortion topic instead. Not mutually exclusive, I’ll grant you, but I did think I was on topic.”Abortion is factually speaking not health care. Its not a medical procedure designed to to treat disease or promote health but to advance a person’s economic lifestyle.” I disagree. I’ve seen too much MEDICAL impact to agree with you there. It is a medical fact that unplanned childbirth at a young age can and will have an adverse impact on the medical health of that individual for the rest of her life, including a lower life expectancy.”This is not a part of my oath. Got it.” I got it too, tho’ I’m not sure which oath you took. I’m guessing Hippocratic, as it specifically forbids abortion. Of course, it also swears feality to pagan gods, so I could be wrong since you go on to say…. “It just so happens this fits nicely with my faith but I’d be just as opposed to killing someone if I’d never heard of Jesus Christ.” Uh, as I recall, I never advocated killing anyone…. “There is a fact based objection to abortion, not just a faith based one.” Never said there wasn’t. In fact, I think I was pretty clear that a doctor should consider facts as well as religion, law, and a host of other factors.If you want to talk about abortion, fine, but let’s leave the sex out of this and get back to the topic, shall we?

  • Anonymous

    If you liked Dr. Sloan’s column, you’ll like his book even more. It’s very interesting.

  • Travis

    Doc,How on earth do you feel qualified to know for certain that there are absolutely no doctors who allow religion to govern their professional behavior related to matters other than abortion?Have you talked to each one personally?Travis

  • Daniel

    MichaelI have heard of real life doctors who comment on their paitent’s sex lives and deny birth control or impotence drugs because of their so-called Christian values, which of course, caused alot of hard feelings. I am not aware, personally, of any other issues like this–just birth control and impotence. If you have other examples, then what are they (in a nutshell)?

  • liz

    My sister who lives in Alabama went to see her doctor concern her weight. She had gained quite a bit when she got pregnant and was still very heavy 2 years later. Her doctors advice: pray to God and try to be a better wife.Needless to say she has a different family physician now.

  • Steve H.

    DOC: If so many of us seem “hyper-polarized” to you, I respectfully submit it is because we have to worry about the very real possibility that you and your like-minded colleagues will adversely affect our health, and that of our loved ones, because of your self-righteousness. It’s bad enough that you claim the right to unilaterally deny us treatments or medications you disapprove of–but even worse that you see nothing wrong with refusing to refer patients who wish to avail themselves of them to other physicians.MARY: Your knowledge of etymology is as tenuous as your theology. According to Webster’s New World Dictionary, “fetus” is derived from the Latin “foetus,” which simply means “bringing forth, progeny” (secondary meanings: “pregnant, fruitful”). “Proles” and “Liber” are the closest equivalents to “child” in Latin.

  • Garak

    The key here is the concept of a profession. Being a member of a profession means putting the interests of the public and your patients and clients ahead of your own. Any professional deviating from this for any reason, including religious beliefs, and especially religious beliefs, ignores this central tenet. A lawyer cannot mount a less effective defense for a client based on their religious belief. A CPA cannot refuse to take a deduction on a client’s tax return for a charitable contribution because the CPA’s religion teaches him that the particular charity is sinful. If a physician can refuse to inform a patient of available medical treatment due to religion, then could the patient refuse to pay because of the patient’s religious beliefs? Or reduce the bill because the physician gave sub-standard treatment (which he did)? Or charge him for his time spent in listening to the proselytization? I’ll bill him at my rate of $500 per hour. Then he can pitch Jesus to me all he wants. May I as juror refuse to convict someone because I like his religion or dislike that of the victims? May I refuse to convict someone because the victim is a christian and I am an atheist?We hear attacks on Muslim countries all the time because they elevate Islam above secular principles. Christians can’t testify against Muslims, christians can’t repair their churches, christians can’t hold public office. This is really no different than the evil of which Prof. Sloan speaks. They both stem from religious supremacism.Prof. Sloan hits the nail on the head with is last sentence: “find another profession.”

  • Bob Jones

    I really believe this entire threat of discussion is a waste of time and that people on here are extreme in both directions. Lets stop bashing doctors and lets stop bashing people regardless of what their beliefs are and lets focus on something that really is important.Thank you

  • TJFRMLA

    DocIf people like you are going to be allowed to practice medicine…I think insurance companies should be required by law to inform patients of your “beliefs” since they directly affect the quality of medical care and the doctor/patient relationship. As a patient I want to know that my doctor puts my welfare before his religious beleifs even if he’s prescribing an asprin. I want the mental comfort of “freedom from religion” when we discuss my well being. I feel I have the right to expect candor from my insurance company. If you have the right to refuse service I feel I have the right to know who you are and if there are more like you in my medical group before I join that specific

  • Bob Jones

    I really believe this entire threat of discussion is a waste of time and that people on here are extreme in both directions. Lets stop bashing doctors and lets stop bashing people regardless of what their beliefs are and lets focus on something that really is important.Thank you

  • Michael (one of many)

    Daniel–Other issues include more dramatic ones like drug/alcohol abuse, but also include diet/obesity, and even ones more mundane like anxiety/mental health, occupational exams, and heck, even cold care. Religious beliefs get considered with everything else, often don’t make much difference, but at least get into the mix. Then there are situations such as when I’m in a state I’m not licensed, and someone calls for help. Balancing legal obligations with religious/medical concerns sometimes have me seeing patients when it literally is against the law (but I’d rather not go into too much detail there for obvious reasons).

  • also a doc

    Ben, your religion is part of who you are, but if your religion makes you a sanctimonious prig who is unwilling or unable to engage in real moral discernement about the complex issues that face medicine today, then you must be able to set it aside or you must disclose the limits of your practice early and often to your patients. As a Christian I think there are worse things that can happen to a person than death, but when I think its time to withdraw care and the family disagrees, its not my place to pull the plug myself or to hide from them that other things could be done to prolong life even if I think them futile and perhaps even cruel. I should not be required to participate in assisted suicide, but neither should I hide the information from a patient or family about the legal option. Not all docs must accept all practices. You are not obligated to treat a patient with Parkinson’s disease with a stem cell derived therapy. But you are obligated to tell your patient that stem cell therapy is available from other physician. You are not obligated to do abortions, but you are obligated to tell patients that you will not do the procedure. I know an OB practice that won’t do untrasound before 22 weeks – so in case they find a fetal anomaly its too late for an abortion. Reminds me of the Pharisees who were also so sure they knew exactly the right way to behave.The truth is, I’ve seen all kinds of people perceive “enlightenment” when suddenly forced to walk a mile in new shoes. Its a constant dance of discernment between defending against ethical relativism and the self-righteous “belief” of the Pharisees imposed on others.

  • Mortified

    If your Dr. is and islamist, does he kill you if you don’t convert before treatment? I don’t want any moslems or koreans docs working on me. If in doubt, I interview.

  • Mortified

    If a doctor is an islamist, will he kill you if you don’t convert before and examination?I don’t want any islamist or korean docs anywhere near me. If I suspect, I interview.

  • hemlock

    All I have to say about the surge in the evangelical right christianity (or any religious fundamentalism for that matter): Be afraid, be very afraid. Fundamentalist Religion is the antithesis to Reason and Progress.And I like to example equating a ‘Christian Doctor’ to a vegan working at a restaurant. The comparison works perfectly. You don’t believe in a particular practice, don’t go into it.Example, I feel very strongly about our environment. When I graduated college, I could have gone to work for a company where I could have made a lot more money than I do now, but I did not sell out my personal beliefs (protecting the environment) for the monetary gain working for Big Oil could have gotten me. I also am a professional, and belong to professional organizations with Codes of Ethics. Some of our codes could be summed up as “practice your profession to not harm the public.”No matter the education level that doctors and pharmacists have to get for their profession, they forget (because we have allowed them to think they are akin to god, recent TV shows don’t help dispell that myth) that they working in what is technically a service industry (just like a waitress, just more education to get the job). And I’ve always wondered why it was more important for fundamentalist christianity to protect the unborn at the expense of the living. Is it because ‘children’ in historical christian teachings do not have souls until 7 days after birth or baptism so you have to do everything possible to get that new body inhabited with a soul so it can then die and give another soul to heaven? And that the mother already has a soul so it’s no big loss if she dies because that’s another soul for heaven? And all christians are really concerned about is getting their soul and everyone else’s to heaven?

  • Bruce Vaughan

    Thank you Mr Sloan for writing this article. This is a subject that is very serious. We currently allow Doctors to control themselves. They had been doing a respectable job until recently. The religious extremist in our society as well as all society need to be controlled. We all understand that religious extremism creates terrorist. This rule follows true for all religions. We must pull the license of any doctor or any other licensed health care worker who beleives that their religious views trump their patients health care.Thank you again for bringing this important topic to the forefront.

  • Bruce Vaughan

    Thank you Mr Sloan for writing this article. This is a subject that is very serious. We currently allow Doctors to control themselves. They had been doing a respectable job until recently. The religious extremist in our society as well as all society need to be controlled. We all understand that religious extremism creates terrorist. This rule follows true for all religions. We must pull the license of any doctor or any other licensed health care worker who beleives that their religious views trump their patients health care.Thank you again for bringing this important topic to the forefront.

  • Patrick

    The other doc wrote…”The Buddha is a deity”I would recommend some serious study of Buddhist doctrine.The Buddha is an actual person named Sidartha/Shakyamuni from the Shakra Clan i India. India actually studies Sidartha in an historical context, not much different than Ghandi, King, or Ikeda. All real people!No deity, a real man. Do your homework before you compare Buddhism to Christianity. I do!No comparison!

  • mcbride

    Doc:Clearly this discussion is not just about abortion. it is also about (as previously mentioned by several people above – with whom i agree) moralizing and passing judgment on people’s sexual choices (predominantly women’s choices btw).and sure, people’s sexual choices may in fact lead to the decision to have an abortion, but those are choices for them, not you to make.what injury does it do to a doctor as a professional if one of his patients is having premarital sex? sure this patient may return to the physician if the consequences of that decision result in the need for medical attention, but even if that is the case (and jeez, how many instances of “sinful” premarital sex occur without medical consequences), then it is the doctors job to treat the patient. just like he cautions patients against smoking, but will treat their emphysema despite it. certainly too this argument applies to the pharmacist – even more so perhaps because it is none of their business why a medication was prescribed and i certainly can’t imagine a woman taking birth control having any direct effect on said pharmacist whatsoever.don’t try to pare this down to something less complex than it really is.

  • yoyo

    The recent bomb attempts in London and Glasgow,

  • Patrick

    The other doc wrote…”The Buddha is a deity”I would recommend some serious study of Buddhist doctrine.The Buddha is an actual person named Sidartha/Shakyamuni from the Shakra Clan i India. India actually studies Sidartha in an historical context, not much different than Ghandi, King, or Ikeda. All real people!No deity, a real man. Do your homework before you compare Buddhism to Christianity. I do!No comparison!

  • also a doc

    DOC wrote: I’ll just say that you and I both know that many embryos don’t need to be created, but are created multiple times for harvesting of their parts. They don’t need to be created often times and they don’t need to be discarded.Are you referring to human embryos? Please give me details of who is creating and harvesting human embryos for parts.

  • ReginaldSkeptic

    Victoria, you asked the rhetorical question: “many different professions are licensed by the state- does that mean a lawyer has to accept every case?”The answer is, of course, no. However, once a lawyer has accepted a client, he or she must do all that the law and the rules of practice permit in representing that client. It would be unethical for an attorney to accept a client in a murder case, and then decide to not vigorously defend that client because of the biblical proscription on murder. The lawyer’s duty to his or her client MUST come before the lawyer’s personal religious beliefs. This is due, in part, to the monopoly that the state grants to attorneys. But more important is the special position of trust that the lawyer has with respect to the welfare of his or her client.This rationale is directly analogous to the position a physician is in. Even more so than an attorney, a physician has a special position of trust with respect to the life and health of his or her patients. A doctor’s first duty, therefore, should be to the patients.For this reason, for someone like “Doc” to say that he is “a Christian first and a doc second” is, to my mind, per se unethical.

  • hemlock

    MCBRIDE: Very true, most religions have always been about controlling women and their sexuality since it’s widely known in religious circles of numerous world religions that women are hyper-sexual creatures that can’t control themselves so they need to be controlled for their own good.It’s funny that some health care plans will not cover prescription birth control because it’s a non-necessary prescrition, but WILL cover Viagra for ED. So it’s medically necessary for a 60 year old man to get an erection???And no, I don’t believe every doctor should be required to perform an elective abortion. Geeze, I’d never walk into my family practioner’s office and say “hey, give me an abortion.” becuase that’s not his specialty.But do I want a doctor to pass judgement on the best treatment for me or my family based on their own personal religious beliefs that I might not share? No, I want treatment chosen based on sound science, and the expected longevity of the treatment. And DOC, Michael is not setting up ‘straw-men’ as you say, he’s providing very rational very possible/probable situations.And btw definition for ‘Straw Man’: A made-up version of an opponent’s argument that can easily be defeated. To accuse people of attacking a straw man is to suggest that they are avoiding worthier opponents and more valid criticisms of their own position “His speech had emotional appeal, but it wasn’t really convincing because he attacked a straw man rather than addressing the real issues.”Personally,I don’t see you giving strong sound rebuttals to Michael, so you’re arguments are more of a ‘straw man’.

  • hemlock

    MCBRIDE: Very true, most religions have always been about controlling women and their sexuality since it’s widely known in religious circles of numerous world religions that women are hyper-sexual creatures that can’t control themselves so they need to be controlled for their own good.It’s funny that some health care plans will not cover prescription birth control because it’s a non-necessary prescrition, but WILL cover Viagra for ED. So it’s medically necessary for a 60 year old man to get an erection???And no, I don’t believe every doctor should be required to perform an elective abortion. Geeze, I’d never walk into my family practioner’s office and say “hey, give me an abortion.” becuase that’s not his specialty.But do I want a doctor to pass judgement on the best treatment for me or my family based on their own personal religious beliefs that I might not share? No, I want treatment chosen based on sound science, and the expected longevity of the treatment. And DOC, Michael is not setting up ‘straw-men’ as you say, he’s providing very rational very possible/probable situations.And btw definition for ‘Straw Man’: A made-up version of an opponent’s argument that can easily be defeated. To accuse people of attacking a straw man is to suggest that they are avoiding worthier opponents and more valid criticisms of their own position “His speech had emotional appeal, but it wasn’t really convincing because he attacked a straw man rather than addressing the real issues.”Personally,I don’t see you giving string sound rebuttals to Michael, so you’re arguments are more of a ‘straw man’.

  • victoria

    as a person who has done volunteer work with people with AIDS for almost 20 years i find it uninformed for people to argue that unwanted pregnancies are the only results of sexual activity. doctors are faced with deep ethical dilemnas every day- many with far reaching after effects- the other doc was railing against pharmacists intrusive behavior which isnt really applicable to this diiscussion. but the ultimate responsibility of the treatment lies heavily on the doctor’s shoulders. i notice no one commenting on the honorable activities of doc- his committment and extra work and energies expended- these are possibly in part based on his own ethical code, and his religion helps him to be true to that. people are making alot of wild conjecture- some downright silliness- for instance- what emergency room is anyone aware of that is so poorly functioning, that they would have an attending physician who is a jehovah witness, and what kind of jehovah’s witness doctor would be so idiotic as to accept an emergency room position? judges recuse themselves from cases all the time. this alarmist and fear inducing comment from mr sloane is another- conflicting loyalties? there has been no instance provided here where danger is iminent. choosing not to perform abortions wont kill anyone. if someone is so unaware of the availability of clinics, planned parenthood, and just dial 311- not giving birth control? also a doc lost me when he made that sly ad hominem characterization- the same depth of conscience that prevents doc from performing abortions (not life threatening) id rather have a doctor that cares too much and whose conscience is too deep than any other. peace

  • Meri

    Religious belief is simply the latest abuse to hit us as patients, but the true source of the problem is when doctors use their position of authority to push their own ideals, biases, predjudices and whims in favor of what is actually best for their patient. The position of “doctor” is not simply a job or even a career. It is a highly placed position of authority under the heading of “public servant”. A public servant must, by the very position of authority and trust granted to them, be able to set aside their own preferences, of any type, in order to conduct themselves in the duties society has assigned to them. Those who decide to withhold treatment, decline to discuss all treatments options, or who provide treatment that is not in the best interests of their patients without the informed consent of the patient do more than simply harm that patient; they undermine the trust that society as a whole has placed in the profession. This latest debate is not a question of freedom of religion for the doctors, though it has been presented that way repeatedly. The license you receive from the state that allows you to practice medicine is an endorsement FROM the STATE that you are ALLOWED to practice medicine and a guarantee to the citizenry that you will do so in a manner that is in their best interests. No where in there is an exception made for your particular preferences or beliefs. And as it is the STATE that has issued the license to you PERMITTING you to practice medicine and elevating you to a position of authority and trust, you are acting as an AGENT of the state when you are practicing. And the STATE is not permitted to impose or endorse any particular religeous beliefs, due to the very freedom of religion often invoked by these same doctors. THAT is why it is a problem when doctors practice their religion first and their medicine second. If you can’t put your beliefs aside long enough to give me the best medicine available then please return your license to the state that issued it and let them know that you cannot, in good concience, act as their agent in the capacity expected of you. Find some other way to fulfill the calling to care for those who are sick or injured, as long as it’s not as a state licenced physician. Shame on anyone who would put their own beliefs above those of someone entrusted in their care, and then have the nerve to scream “freedom of religion” when their actions are questioned.

  • also a doc

    Patrick, if you’re going to quote me please refer to the quote in context, and either bother to look up what I actually said so you can quote me accurately, or else don’t use quotation marks on words that I didn’t say so that people can tell you’re paraphrasing and not quoting me. Thank you yoyo. Watching Americans diss Islam because it puts religion above freedom, science and the free flow of ideas, while those same Americans are trying to use religion to suppress freedom, science and the free flow of ideas, is something of an other world experience.DOC, what did I miss here? It seems like you say abortion can improve the health and longevity of the mother, then you go on to say its only purpose is to improve her economic life. This appears to be a contradiction: ” It is a medical fact that unplanned childbirth at a young age can and will have an adverse impact on the medical health of that individual for the rest of her life, including a lower life expectancy.Abortion is necessary to preserve life only, I will agree with it in that case. 99% of the time its a lifestyle choice that kills a developing child so someone can have a better economic life.

  • Jack

    People should have the option of going to a Witch Doctor, Shaman, or Fundamentalist Christian doctor, but it should be absolutely clear that it’s not the same as a real doctor, who would be guided by state-of-the-art scientific medical knowledge. The medical powers that be should get these other circus acts out of the mainstream medical profession – all 14% of them.

  • Anonymous

    Victoria:The reference to a JW in an emergency room is valid, although unlikely. An employer is prohibited by law from asking on an application the religious affiliation of a job applicant. In the same vein, an employer is prohibited by law from firing an employee based soley on religious beliefs. So if by some unforseen circumstance a hospital hired a JW as an emergency room physician they would then have the burden of proof in firing said JW that termination of employment was due to sub-standard care and not based on religious beliefs.And as to Planned Parenthood. You must live in a city with Planned Parenthood nearby. What about the population that live in tiny little cities in the middle of nowhere, (think Wyoming, Montana, Kansas, Texas, etc.) that don’t have a PP readily available to them? How easy would it be for them if they drove 300 miles to the nearest city that might have one or two doctors or one Pharmacy to request or fill a prescrition and they are refused?And since the topic seems to be so skewed to just abortion, if abortion and birth control are ever made totally illegal, we should also force everyone who believes that/voted for it to be required to adopt an unwated child. Children should not be a punishment, they should be a wanted outcome. And do tell, what should the jail time for a woman who has an abortion be?

  • ReginaldSkeptic

    Victoria, I do not understand the relevance of your comment that “judges recuse themselves from cases all the time.” Judges recuse themselves from cases where they have, or at least appear to have, an interest in one side prevailing over the other. But regarding the doctor/patient relationship, the only “side” is (or should be), the health and wellbeing of the patient. So I do not see your analogy as being particularly apt.

  • victoria

    reginald skeptic- well, the seminal point is in the acceptance of the case. i would say that when a doctor refuses to perform any procedure (such as abortion, obviously) that is in effect a REFUSAL of the case. i think meri put it quite well- however we as patients also have some repsonsibilty to be intelligent and proactive regarding our treatment. if we act like passive and mutely irresponsible puppets- and use our intelligence – for instance- i want birth control pills- o, you do? besides, as stated by the panelist mr sloane, 86% of the doctors will prescribe them. why do people who insist so vocally on being respected for their own views, maybe non-main-stream- become so hypocritically offensive and intolerant when others have differing views? its a puzzlement

  • pv

    This is part of why doctors are no longer pillers of our community.

  • Garryh

    If you can’t keep your religious beliefs out of the decision making process of determing my care, you are elevating your personal belief system above mine. Doctors are to honor their patients wishes, customs, and religious beliefs. Any Doctor who cannot do this should be required by law to specify same and patients can decide whether that is the kind of doctor they want or not. Full disclosure should be required by law.I actually believe that drugists, doctors, nurses, lawyers, etc who represent a person’s best interests should never be allowed to preclude someone from getting the treatment or defense they want and deserve because of the caregiver’s personal beliefs. Religious freedom is exactly that and anyone who denies my religous freedom should not be licensed by any governmental agency for anything.

  • Anonymous

    “Abortion is necessary to preserve life only, I will agree with it in that case. 99% of the time its a lifestyle choice that kills a developing child so someone can have a better economic life.”Abortion and birth control might also be necessary to provide an adequate quality of life for the children that were previously born or to prevent death after birth. Look up the concept of “little angels” in South America. If you don’t know the concept, don’t bother replying until you’ve read about it and the horrendous quality of life those children have and are forced to have due to abject poverty and their religion disallowing any form of family planning.

  • yoyo

    How do you make people believe superstitious nonsense?Get them when they’re young.

  • ReginaldSkeptic

    Doc, if you want to “stick up for the right of the next ‘you’ somewhere to be born and to have a life”, then that’s fine. What’s would not be fine would be for you to place your personal religious beliefs ahead of the medical needs of your patients. That would be unethical.Do the politicking on your own time.

  • Nelly

    Victoria said: people are making alot of wild conjecture- some downright silliness-for instance- what emergency room is anyone aware of that is so poorly functioning, that they would have an attending physician who is a jehovah witness, and what kind of jehovah’s witness doctor would be so idiotic as to accept an emergency room position?Sully said: When you’re in a car accident and 3 months pregnant and you uterus is crushed and you need a historectomy to prevent bleeding to death, which of course means aborting the fetus, ask yourself whether doctors should be allowed to practice if they can make decisions decided FOR THEM by a church or non-medical group and your benefit is a secondary consideration.I’m sure weather or not sully’s example or my own could happen or not. Maybe it wouldn’t happen maybe it would. Despite how silly it may sound, it’s not really my question. My question is; who protects me? Who prevents me from being unwillingly sacrificed? If my assigned Doctor, in an emergency situation, where time is critical stops fighting for my life, who will fight for my life? In an isolated Christian area, would there even be any anyone who would notice? Have I lost my rights in this area?Yes I am alarmed. I have not herd one assuring thing yet.

  • victoria

    again youre playing with words reginaldskeptic- you left out the all important word- CONFLICT OF INTERESTS- the interest in one side is implied- as in CONFLICT of conscience. as in ACCEPTANCE of a case or treating a patient. so, if a doctor has a conflict of conscience in the case of . lets say the hypothetical patient seeking an abortion- his refusal to perform it would be the end of his responsibilty to the care of the patient- and the patient is free to seek treatment elsewhere- so there would be no doctor/patient relationship established. as to the anonymous person who said that laws preclude any employer asking ones religion- all Jehovahs witnesses carry cards stipulating their religious affiliation and opposition to transfusins- requesting saline solution instead- which in the majority of cases is sufficient. i didnt comment on the employer- i commented on the intelligence of the physician who would be so short sighted as to work in an emergency room and never have it occur to them that htis situation may arise. on the one hand- you say what about the women (or girls) in kansas who have to travel 300 miles for birth control- and then you say that children should be a wanted outcome. also planned parenthood has an extensive network and referral service. if youre in a relationship, and the possible outcome of your activites is a child- you should either be prepared for and deal with that real possibility- or wait until you are adult enough to be culpable for the repurcussions of your actions. i remember a line from austin powers- well, that boat has sailed, hasnt it? as for garryh- well garryh- doctors arent genies in a bottle bound to be subservient to ‘our wishes’. theyre people who deserve the same freedoms that you are espousing for yourself. exactly. also planned parenthood has an extensive network and referral service.

  • JERRY KING

    if doctors are allowed to let religion interfere with science then any dr. who would do such a thing should be forced to advertise that fact allowing patients who need medical care the right to find a dr. who would not allow such interference in his medical practice.

  • Gaby

    Thankfully I have never been put in a situation where my doctors (or phrmacists) were Christians first and physicians second. That is a vey good thing, because I would lose it, before seeking out another doctor. That would not be a nice sight.I work in the public sector, I can not withhold any government services from anyone, just because my religion forbids it. And that is how it should be. Your religion should be a guideline for your own personal lifestyle, but surely not to dictate that very lifestyle to your patients.Say I were opposed to the gay lifestyle, should i be allowed to withhold public assistance from gay citizens? Absolutely not!!! The same should go for doctors and pharacists!!!

  • ReginaldSkeptic

    Nelly said: “My question is; who protects me? Who prevents me from being unwillingly sacrificed?”The only thing that can protect you, or any of us, is the unwavering commitment of the physician to put our care ahead of all other concerns. Without that, we are all at risk.That is why “Doc”‘s comments have been so troubling — He expressly puts his religious beliefs before his concern for you as his patient.

  • ccatmoon

    Keep YOUR religion AWAY from MY body. If you believe that Christianity = helping the poor, then go be a missionary or run a food bank. But DON’T get a medical degree and impose your religion’s view of “helping” on those who may not share your religion. Otherwise, you are not practicing medicine – you are PREACHING.States should not license physicians who put their own religion over the well-being – not to mention LIVES – of their patients.

  • Anonymous

    see…”Why are we so afraid of offending Muslims?”by Christopher Hitchins,at Slate.

  • Meri

    Also a doc,”But, the case is assigned to another judge, and the plaintiff or defendant is given the opportunity to have their issue adjudicated by a professional who feels they can put their duty to the law above their personal feelings on the case. How does this compare to a doctor who fails to inform a patient that he/she cannot put their personal feelings aside in their case, or who fails to inform them that there are other options for their case?”I think the analogy Victoria was trying to make (and correct me if I have this wrong Victoria) is this:A judge, presented with a case in which his beliefs present a conflict of interest will recuse himself from the case so as to not have the case handled unfairly. When he does so the case is allowed to move on to the next judge in line.The correlary is that a doctor, presented with a medical situation in which his beliefs are opposed to some or all of the available treatment options, is ALSO in a conflict of interest: his beliefs vs the patients best health interests. The doctor, if he were acting in the same manner as the judge, should notify the patient of the conflict and allow the patient to be seen by another doctor. Or, in the case of an emergency, put his personal beliefs aside in order to provide the care required until another doctor is available to take over.What is happening in the cases referenced in this article, however, is the equivalent of a judge taking on a case despite the fact that he knows there is a conflict of interest and without even notifying those involved in the case that there is a conflict of interest. The judge, in this example, may even decide to take on the case because it would also becontrary to his interest to allow someone else to hear the case.I think Victoria was trying to point out that doctors whose beliefs and morals run counter to the patients interests, should “recuse” themselves from the care of that patient and allow another doctor to take on the “case”.

  • also a doc

    now doc, I didn’t mean that all religion is out out to suppress freedom and ideas, and I suspect you know that. You would be taking my remarks out of context. Believe it or not, I sing in a church choir and used to teach Sunday school. Science only tells you how (or at least the latest theory of how), it doesn’t tell you why.But I am deeply troubled by the way that people of faith in this country have been used to push a political agenda that suppresses freedom of ideas and science. And sadly, their ideals are played on so slyly that it has taken them a long long time to catch on, in fact many still haven’t grasped that their faith has been shrunk into a coupld of wedge issues by people who couldn’t give a damn about clothing the poor or feeding the hungry.. I find it astounding that the same people who stand up and decry Islam are so often the same ones trying to get the Christian religion to trump science in school curricula, or prevent women from access to birth control.

  • TJFRMLA

    DocJust curious…any adopted kids?

  • Vivi

    My mother (78) recently went to see a specialist for tests. He casually inquired how many children she had (9). He then proceeded to ask if we were all practicing Christians (No, 4 out of 9). He related how sorry he was that 5 of us would be going to hell. She replied we were all good people, and that God would not be sending any of us to hell. You would think that would be the end of it, but no. He insisted that she was wrong, we *would* be going to hell, and she had obviously failed us as a parent. Boy was she mad! You really have to work at it to get my mother to tell you off.Since the event occurred, I’ve related it to about 20 friends, colleagues, and acquaintances. I’ve been shocked to find that almost all of them had similar stories. I imagine I’ll be mocked by some for presenting mere anecdotal evidence that the intrusions Dr. Sloan speaks of really do happen, and happen frequently, but I think I’ll throw it out there anyway. I suppose my mother should be happy that she found out about this fellow’s opinions before he could inflict any real harm on her, beyond the grave insults. And that, also, seems to be one of Dr. Sloan’s points: No stealth religiosity in medical care, please. If you’re going to run a “Christian” (fill in the blank there) practice, make sure it’s on your shingle out front, in your Yellow Page ad, and in the description you provide of your services to insurance carriers. If people decide to see you, they will know they need to ask questions about how your religion will impact their care. Don’t you think that’s fair, DOC?

  • Anonymous

    Doctors might want to help people, but they want to big house, the big $$, the respect and god-complexes, and to get rid of the starter wife more than they want to ‘help out of the goodness of their hearts.’ otherwise medical expenses wouldn’t be so outrageous.

  • ReginaldSkeptic

    Meri and Victoria, you are both using the term “conflict of interest” in a way that is inconsistent with both the the code of judicial conduct and the rules of professional responsibility.But that is not the main problem with your analogy.However, in many medical situations, including (but not limited to) emergency room care, that is not an option. Moreover, you are both glossing over an important distinction. When a physician DOES accept a patient, but does not adhere to the standard of care for that patient because of his religious beliefs, and does not advise the patient of all of the options that the patient may have available (again because of the physician’s religious beliefs), then that physician has behaved unethically.To go back to a legal analogy, a few years ago so-called “Business Method” patents were much in the news. Amazon.com was widely derided for getting a patent on a “one-click” online purchase. Those business method patents were, and continue to be, controversial both in the business community and with the public at large.Now, if you were an intellectual property attorney, and you accepted Amazon as a client, even though you were personally opposed to business method patents, how should you represent them? Should you protect their trademarks in their name and logos, protect their copyright in the software that they developed, but never mention to them the possibility of protecting this business method with a patent? Or should you put your personal feelings aside and represent your client as vigorously as the law and legal ethics allow?The latter is of course the ethically correct answer.The same principle is at least as true for physicians as it is for lawyers. Once a physician has a patient under his or her care, then the needs of the patient must be paramount. If a physician is unqualified to perform a procedure, or simply does not do that procedure, that physician still owes that patient, at a bare minimum, absolutely full disclosure on what treatments are available and what the medical pros and cons are for these treatments. It is nothing short of unethical sophistry for a physician to say to himself “Well, I’m treating this patient for this condition, and treatment A is available for that condition, but I find treatment A to be against my religious beliefs, and so I decline the ‘case’ of providing treatment A, but I will advise the patient about all other treatment options that are available”.

  • HeyYOU

    Being that this is a free market driven economy without the need of regulation and that the consumer should be the driving factor in a person or company’s rise or demise; that all or nothing approach is anethema and the whiners should be told to shut up and sit down.

  • HeyYOU

    Nellie, Please DO NOT speak of that which you know NOTHING about. The Catholic religion IS NOT Christian and has absolutely NOTHING to do with Christianity of the 1st or LAST generation of the Church Christ died and lives for. To equate the two is to show your bias against the Lord Jesus. Please learn and THEN speak or better yet, be born again so you CAN speak intelligently and not like one of the many heathens who spout nonsense here.

  • Anonymous

    HEY, is that YOU?

  • gary

    this article must have been written by someone with a lot of time on their hands.

  • HeyYOU

    YOU got it.

  • ReginaldSkeptic

    HeyYou said: “The Catholic religion IS NOT Christian and has absolutely NOTHING to do with Christianity of the 1st or LAST generation of the Church Christ died and lives for. To equate the two is to show your bias against the Lord Jesus.”Nothing like a little anti-Catholic bigotry to spice things up!

  • TJFRMLA

    HEYYOUIt’s not about whinning. And you’re pretty ignorant if you think it is.

  • Annie

    Would you provide a reference to verify the fact that the Wisconsin legislature considered a bill to allow doctors to refuse to administer a chickenpox vaccine and not inform the child’s parents of the availability of this vaccine? I tried to google this information, but only pulled this editorial. A reference to the bill and the date of the legislative debate would be helpful.

  • Roy

    My religious beliefs are none of my doctor’s business. I don’t want his / her religious prejudice (all religions have it) interfering with my treatment. Case in point were my Mormon teachers in Utah, some of whom gave me Bs instead of As (deserved by precedent, test scores and participation). They had predetermined notion that a “gentile” boy couldn’t be as smart as a Mormon and the grades they gave me reflected their bigotry. I don’t want a religious fanatic doctor with a pre-conceived notion (counscious or sub-conscious) interfering with my treatment and recovery. Neocon Christian extremists have no respect for privacy and this spills over into the medical profession

  • HeyYOU

    Ahhh TJFRMLA your true feelings and motivation come glaring blaring out. Its not about you having the self control and responsibility to get informed about your doctor, its about your NEEEEEEEEEED to freely get an abortion BECAUSE of your NEEEEEEEED to treat abortion as birth control HAVING NO concern for the life you murder while DEMANDING we support you and your cohorts in this endeavor! NO!

  • The Moderate

    Actually, that is “First do no harm…”.Wow. The theophobia on this site is so thick you can cut it with a knife. Especially anti-Christian paranoia.Perhaps the surgeon read the New England Journal of Medicine meta study that suggests a weak beneficial effect of prayer on medical outcomes. No there was no denomination that worked better than the others.To say that he “requests” in quotes implies that there is some coercion involved. Does anything bad happen if the people say “No thanks, Doc, I am not a believer.”? Having lived for much of my adult life as an Atheist, I have had no cases of any problem with people who knew I did not share their beliefs. In the cases where I said, “No thanks, friend, I am not a believer.” I have always been treated with dignity, courtesy, and respect.Perhaps Sloan should “find another profession.”, or at least take his paranoia off the air.

  • Vivi

    HEYYOUNellie never said anything about Catholics, TJFRMLA never said anything about wanting abortion on demand. I’m trying to decide if your comments are all tongue-in-cheek, or if you really mean it.

  • Vivi

    HEYYOUNever mind. I decided I don’t care.

  • The Moderate

    Roy,Did you consider the possibility that your papers really worth just a B?The Mormons I know are decent folks.

  • Nellie

    Catholic or Christian, In the context of personal health care, Both would rather dictate to me then consult with me, making both, as Physician, equally dangerous to me.

  • The Moderate

    Nellie,Most of the great hospitals in the United States were founded by Catholics, Jews, or Protestants. There are a few exceptions, of course but that is true in the main.They ALL give first rate care to people of all religions or no religion. Don’t be taken in by the paranoia this loony site sells.I look forward to the great hospitals that the Moslems, and Pagans, will found, in time, too.

  • victoria

    nelly- i believe doc already indicated that in the case of the life of a mother and an unborn child, measures are taken to save the life of the mother – however i may be wrong.reginald- did it somehow escape you that the basis of the analogy was that the patient was not under the doctors care? while you seem focused on one analogy out of several- it still doesnt hold water. what emergency situations were you thinking about reginald? as for also a doc- why imagine i would be bored? im sorry for the bad experiences mnay many have had at the hands of intolerant controlling judgemental power abusing humanoids posing as doctors and using their religions as a cover for their own bad behavior. that doctor you know who trumpeted that god made the person sick and they should be put to sleep like a sick kitten was a sicko unit. actually if you want to be more literal as a christian (which im not by the way if it matters, which it does not) then compassion would be the overwhelming sentiment- i had power of attorney for a man who wanted ‘no heroic measures’ taken- i think what is so upsetting to people is the thought that they may be in a helpless situation and that some doctor will be abusing his position to ‘play god’ and make life and death decisions based upon religious beliefs, as opposed to scientific training. certainly this is an overwhelming and real fear- in any situation of course it is wrong to coerce or take advantage of a weakened person. im not seeiing this tendency in the short communications by Doc, perhaps he could clarify. MERI- you said it better than i did. VIVI- just as it would be illogical to take one line of scripture and develop an entire philosophy from it- it is also illogical to take one incident in your mothers life and judge all doctors by the actions of one. i always tell my husband for any undertaking i have plan A

    REGINALD- that is interesting what you said- i just hired a lawyer 3 days ago, and said to my brother in law when he asked what my criteria was- that i believe there are 2 kinds of lawyers- those out for a buck, and those who care and want to effect some good change or maintain justice. i believe there are some doctors who are healers and called, and some who fall into or want to make a buck- but its not as often as people imagine- it takes alot of fortitude to make it through med school on the driving force of moolah alone. o well, sorry ive gone on like i do peace

  • barker

    The essay misses the point somewhat by blaming religion and religious people as the sole culprits in so-called spiritually-based health care delivery distorations. Specific to vaccinations, as a former private school director, our biggest health problem was uninformed parents — citing the latest trendy quack misinformation — insisting that immunizations be avoided at all costs — risking the health and lives not only of their own children but of classmates and staff as well. That states sanction such ignorance under the guise of the hallowed god of “tolerance that gives no offense” is frustratrating to those who seriously want to protect lives and likewise understand some of the reasons why people tend to live longer and better quality lives today than they did 60 years ago. Religion does not deserve the blame leveled at it by this article. Ignorance on all fronts is the enemy.

  • Laura T. Rahe

    So let me get this straight: the law should force medical professionals to perform procedures they, for religious or other reasons, believe to be immoral? Apparently, freedom of conscience is controversial, and things like pluralism and toleration are out the window.

  • HeyYOU

    Jozevz et al, DNA evidence has PROVEN your whole belief system IS based on a lie. I so wish I was a Lawyer, I would immediately file a class action lawsuit to reclaim the tithes your religion force the gullible to pay. It is amazing to say but your religions is more insidious than what the priests did to those they molested. Joseph Smith was a liar. In todays culture he would be arrested as a child molester and jailed. The indigenous indians from north to south America ARE NOT decended from the Jewish nation. You have been lied to! LOL!

  • HeyYOU

    JOZEVZ ET AL, Your under the influence of something.

  • Ed Scott

    Could you please give me a link to the Des Moines Register article(s) regarding the Iowa City VA hospital? I could not find anything using searches.

  • Norrie Hoyt

    A suggestion for patients whose doctors won’t provide certain prescriptions, medical treatments, or referrals, because s/he thinks that doing so would be against their religion:Consult a lawyer for advice on suing the doctor, not for malpractice, but for breach of contract.A physician who accepts a person as a patient without conditions has implicitly held himself out as a doctor who will not refuse to provide certain advice or treatments because of his or her own religious objections.Ask your lawyer about suing them for damages and punitive damages, and filing a complaint with the state’s Medical Board.Even if you don’t collect anything, you’ll at least have caused them as much grief as they caused you.And be sure to publicize your lawsuits and complaints in the media. The docs will really love the bad publicity about them, and so will you.

  • Anonymous

    Thank You Mr. “THE LION”. Huggs n kisse to ALL the Brethrens & Sistars! You Too! Ya Ya. Good n Nacht! YaYa.

  • tom

    “Find another doctor” is the facile answer to this one. But how do you find out that the first one was a Christie A*hole who is acting on his religious principles rather than trying to keep you alive and healthy?

  • G.A. McLeod

    This article assumes that one’s religious beliefs do not correspond to reality, but are simply a sometimes useful delusion. Part of what bothers me about this article, and contemporary secularism in general, is the assumption that religion is the realm of “personal belief” and has no bearing on, as the author says, “the interest of your patients.” This is certainly just to assume that any religious belief is false, and the author presents no argument for this position. If a doctor have a religious belief that abortion is impermissible, for example, and refuses to perform an abortion on those grounds, the doctor certainly takes this to be in the interest of the patient, as presumably they take their religious belief to be true, not simply some make-believe ethic imposed on the patient for some reason. Evangelization is similar. If we give religious people enough credit to assume that they actually believe the religious principles they hold, then presumably they DO think it’s in the best interest of the patient to convert them. Perhaps such a view would be false–but the author has given us no reason to think it is, and this is what is needed if we are to accept his conclusion.

  • Tom

    “So those who refuse to abort children should not be permitted to become doctors?” Yup. The Priesthood beckons…. Fewer Aston-Martins, but all the perks of living their faith!

  • Tom

    If my doctor diagnosed me by reading chicken entrails, I would at least ask for a second opinion! But I could do so, only if he informed me of his methodology.

  • Tom

    In an age when many, if not most, people are served by HMOs, who assign doctors pretty much by lottery, “choose another doctor” is NOT an option!

  • Deneen

    Doctors, like everyone else, have the opportunity to be of any faith that they choose. Instead of villifying doctors for refusing to practice certain treatments because of religious beliefs, let’s take a hard look at insurance companies that are dictating healthcare rather than allowing doctors to do what they spent hundreds of thousands of dollars to do: practice medicine.

  • Tom

    Just consider: without disclosure, you could have Jacob Jozevz as your doctor!!!!!!!!!!

  • victoria

    i like jovez- s(he) has an instinct for ferretting out hypocrisy- (thats a nod to your universal gender transcendentalism jacob) ya ya MODERATE- id say your experiences are based on your always exceptional manners in dealing with people. for the record moderate- the first hospital ever created was by a muslim. just a little known fact. G.A.MCLEOD- very asute indeed. BARKER- i also appreciated your input. i looked hard for an opposing viewpoint of reason- but its getting kind of shrill-

  • S. Wadley

    Richard Sloan’s position would be much more supportable if I believed for a moment that his points would be directed towards a physician that objected on personally-derived ethics and not “religious values.”

  • Verse Infinitum

    The Hippocratic Oath is the most significant form of professional affirmation and service cohesion that is uniformed worldwide despite religion, despite the various types of economies a country abides by such as Capitalism, Communism, Socialism, etc., despite language, despite nationality, despite cultural history and genealogy, despite the types of governments such as Republics, Monarchies, Dictatorships, Confederations, Military, etc. Medical professionals are obligated to serve the patient. A doctor’s sole obligation is to practice their craft only for the good of the patient, if that can’t be done at least do no harm.

  • Nick

    Apparently, 14% of U.S. physicians, representing different regions of the country and different medical specialties, believe that their personal religious views rather than the needs of their patients should determine which perfectly legal medical treatments they offer and, more distressing still, that they are under no particular obligation to disclose this bias to their patients or to refer them to other physicians who will offer the treatment. This is unethical and these physicians should resign their practices and seek other careers. Religion and medicine should always remain separate. Treat the body with any and all available treatments. Treat the mind separately. To do anything else just goes to show how corrupting the pride of religious belief is and how it has hurt rather than helped humankind throughout our checked and painful history. Religion is not the answer to everything, and should never govern the practice of medicine. Like the true believers in conservative ideology, these people wear blinders that prevent them from doing what in right in favor of what the right wants them to believe. 14% of physicians are jerks, a**holes, and idiots.

  • Nick

    Apparently, 14% of U.S. physicians, representing different regions of the country and different medical specialties, believe that their personal religious views rather than the needs of their patients should determine which perfectly legal medical treatments they offer and, more distressing still, that they are under no particular obligation to disclose this bias to their patients or to refer them to other physicians who will offer the treatment. This is unethical and these physicians should resign their practices and seek other careers. Religion and medicine should always remain separate. Treat the body with any and all available treatments. Treat the mind separately. To do anything else just goes to show how corrupting the pride of religious belief is and how it has hurt rather than helped humankind throughout our checked and painful history. Religion is not the answer to everything, and should never govern the practice of medicine. Like the true believers in conservative ideology, these people wear blinders that prevent them from doing what in right in favor of what the right wants them to believe. 14% of physicians are jerks, a**holes, and idiots.

  • Jenny

    I agree with this article, but it ignores the much larger issue of parents who refuse to vaccinate their children. I am a critical care nurse, and the number of patients and parents that refuse to comply with medical recommendations dwarf the number of physicians who give inappropriate advice. Noncompliance is a huge issue in healthcare, one that has been largely ignored by the media.

  • Bruce Hempel

    Richard Sloan seems to be oblivious to the fact that nothing supercedes an individual’s conscience. Based on his reasoning, there is no reason why anyone has any right to refuse to do anything. To him, the state is supreme, not God, nor conscience. His arguments run counter to the positions of people like Thomas More, the founding fathers, and Alexander Solzhenitzen.

  • LG

    “so those who refuse to perform abortions should not be allowed to become doctors…”No, but those who refuse to counsel their patients that abortion is a medical option for them or doctors who refuse to refer a patient for an abortion if requested are NEGLIGENT!”Physicians have a professional obligation to inform their patients of all medical options available to them, this is called “informed consent”. Physicians who do not provide informed consent are negligent.

  • LG

    “so those who refuse to perform abortions should not be allowed to become doctors…”No, but those who refuse to counsel their patients that abortion is a medical option for them or doctors who refuse to refer a patient for an abortion if requested are NEGLIGENT!”Physicians have a professional obligation to inform their patients of all medical options available to them, this is called “informed consent”. Physicians who do not provide informed consent are negligent.

  • al morgan

    Faith intrinsically is above your profession. Its above yourself, its above your family, its above your country. If not, its not much of a faith, is it? And it doesn’t even matter if the profession requires something as antiquated as an oath. So to simply imply faith is something that can be shoved aside when you walk into the office, never to be considered in all your decisions you make I think trivializes it. And why can’t the patient find out from his friends, or the doctor what he thinks? Why must the doctor where a badge saying what faith he has…sort of resembles discrimination. In many professions there are many ways to get the job done. Bridge design being a recent example. And the doctor isn’t totally separate from the patients treatment, the doctor’s experience with it and comfort with it can affect the treatment that the statistics don’t tell.

  • TEL

    G. A. McLeod:”then presumably they DO think it’s in the best interest of the patient to convert them.” Your remark completely misses the point. I don’t go to a doctor for spiritual guidance. A doctor’s speciality is in the physical well-being of a patient. They have no right, or any special insight to presume the patient’s spiritual well-being. While you mention evangelicals, I imagine if you went to your doctor and they attempted to indoctrinate you into some other form of belief, you would be offended. And you would be right to be so, since the doctor is supposed to be giving you a physical, not proselytizing.My spiritual beliefs are a fundamental part of myself that I share with my loved ones. Why would it ever be O.K. for a doctor to make such a presumption on my life, any more than for the checkout clerk, the mailman or any other person who is only incidentally a part of my life? I know doctors are trained to behave as if they are God in the exam room, but get real.While I have no problem with doctors choosing to practice medicine while taking religious beliefs into account, they should be honest and tell potential patients BEFORE any services are provided how those beliefs affect their ability to treat me (ie, prayer in the exam room).As I said in an earlier post, my largest concern is with a doctor’s competency.

  • Dave

    Doc:Do you like child neglect?Do you like child abuse?Do you like disinterested parents?Do you like burgeoning prison populations?Do you like infanticide?All of these occur as the result of people giving birth who don’t want to face the responsibility of parenting. You can make abortions illegal. But you can’t force parents to parent.Like most pro-lifers, your concerns seems to stop once the umbilical cord is cut.By the way, now do you feel about universal health care, so that this nation’s 47 million uninsured–many of whom are children–can afford your services?

  • Anonymous

    We should look forward to a future when religion,its veracity ruined by its very diversity,will be laughed off the world stage as being so much tomfoolery.

  • John Stackhouse

    Professor Sloan is half-right and half-wrong. I blog about this at length, so I’ll just say here that he is right to be unhappy about evangelizing physicians (I say this as an evangelical who likes both evangelism and medicine!) and wrong about physicians in our pluralistic society not being allowed to demur in areas of ethical controversy.The Hippocratic Oath, after all, begins, “First, do no harm.” Professor Sloan surely does not want all physicians to do whatever the State tells them to do about what is, and isn’t, harm? God forbid!

  • Yussy

    This story is a beat up. I suspect Mr Sloan is more into promoting himself than dealing with any “real” problems that might exist in the field of medicine.As to be expected many of the comments put forward by the Atheist whingers are void of rational thought. The comment posted by Nellie August 9, 2007 12:28 PM being a typical anti-christian rant:Like Mr Sloan’s story Nellie’s comments is short of facts and is written simply to promote lies and hate against Christians. She says:So Mr Sloan stop trying to sensationalize a non-issue in order to give the anti-christian nutters like Nellie a platform to speak.

  • The Moderate

    Dear Victoria:”MODERATE- id say your experiences are based on your always exceptional manners in dealing with people.”Thank you.”for the record moderate- the first hospital ever created was by a muslim. just a little known fact.”Sorry, not even close. Galen, a Roman physician developed the surgical scalpels, clamps, and so we still use today in 100 AD well before the Moslems existed. He ran a hospital system for Marcus Aurelius’ Roman Legions. The soldiers were so expensive to train the Galen was hire to set up hospitals with sanitary surgeries, convalescent wards, nutritionists, and more. In every way except for electricity, it was a modern hospital system that he ran. Galen was much more careful about post operative infections than we were in the US in, say the Civil War.

  • Meri

    Thought I would throw out another reason why it is wrong for doctors to put their beliefs before their patients’ care. By practicing your beliefs first and medicine second, you are forcing the PATIENT to take on the responsibility of accomodating your beliefs. A patient entrusted into your care for the benefit of their health should not be put into the position of being responsible for providing you the means of practicing your faith. You are a doctor, your responsibility is to the patient first when you are acting as a doctor.Additionally, you are being PAID to provide a service. When you charge a patient for an office visit, and then refuse to provide the care that they require, or withhold certain treatment plans, you are now making the patient financially responsible for your expression of faith. As there is an expectation of the services provided for said fee, it is also possible you are commiting fraud by not providing services as expected. Even if the patient’s care is being paid for by an insurance company, you are still getting paid for a service you have not provided and in this case would be holding the insurance companies responsible for accomodating your beliefs.As a patient I have a right to expect that the doctor caring for me will provide the best care possible for the benefit of my health. Doctors are entrusted with the responsibility to their patients’ health and I am paying for these services. Why should I be the one to bear the burden of accomodating your beliefs, perhaps to the detriment of my health?

  • Cary

    Tel wrote “My spiritual beliefs are a fundamental part of myself that I share with my loved ones. Why would it ever be O.K. for a doctor to make such a presumption on my life, any more than for the checkout clerk, the mailman or any other person who is only incidentally a part of my life? I know doctors are trained to behave as if they are God in the exam room, but get real.”

  • Solomon

    I agreee. Evangelizing is bad for medical profession and overall as well.

  • mcbride

    so, when a christian scientist or jehovas witness has a sick child who comes under the care of a doctor, i believe that the doctor can remove the right of medical guardianship from the parents temporarily such that the child can be treated (against the parents will).

  • Anonymous

    When I was a young man (late teens-early twenties) I had questions about life and about how one should behave,etc,etc. So I picked up a copy of The Ethics of Aristotle,and later Plato’s Republic,and eventually to Marcus Aurelius and Montaigne.

  • Gaby

    Hey, Jacob, my Eclati-on friend, how is that book coming??? You better hop to it, it’s almost the middle of August. Ya Ya!!!

  • TEL

    Cary:You presume alot, particularly about me and my beliefs, which you know nothing about. If you want a doctor to pray with you instead of conduct a physical, then by all means find one willing to do so. A doctor’s appointment isn’t about the doctor, it is about the PATIENT. A service is being provided, plain and simple. And it is never OK to proselytize to someone who doesn’t want it. I notice you say nothing about my actual point. For example: how would you feel if you had a Dr.’s appointment, and a doctor tried to convert you to islam? You should remember that not all doctors are evangelicals before you defend prayer in the exam room.I was taught growing up that each person has a right to their own beliefs, and that it is disrespectful to push those beliefs onto anyone who wasn’t interested. It may surprise you to find this out, but alot of people are raised like that – to respect others’ beliefs. So to answer “why won’t I share my beliefs”, my response is, why do you feel you have the right to impose your beliefs on someone else?

  • TJFRMLA

    As I said before…FULL DISCLOSURE BEFORE TREATMENT.

  • yoyo

    AL MorganI’m sure the 9/11 suicide bombers would agree with you

  • Meri

    One of the troubling assumptions being made by doctors who insist on practicing their faith first and medicine second is that their right to religious expression trumps all other concerns. People have been given other rights, in addition to freedom of religion, and when two or more of those rights are in conflict, one must be seen as more important than the other. In this case, your right to free religious expression ends where my right to live a healthy life begins.Personally, I don’t think that any state licensed doctor practicing medicine should be allowed to withhold any treatment based solely on their religious beliefs. However, a more practical method that I would find acceptable would be one of full disclosure. If your religious beliefs are in conflict with potential treatments for your patients, the patients should be notified of this fact prior to their first appointment with you. That way they can find a different doctor to go to prior to being accepted into your limited care. If you are going to withhold treatment, the least you can do is NOT withhold that bit of information from your patients.

  • Trial Lawyer

    Doc,If you ever make a mistake in your (admittedly truncated) practice, I cannot wait to elicit your “Christian first-doctor second” proclamation on the stand. Can you say, “bankruptcy?”

  • yoyo

    The U.S. perhaps more than any other western country,

  • Cary

    Tel,You are right. I don’t know you and I apologize for my presumtions about your faith. I just wondered where the loved ones end and other people begin. If I am sharing my beliefs it is just that, sharing, not imposing. No more than telling someone about a restaurant you loved would force them to eat there.

  • private

    I had an unethical doctor once who suggested my bipolar disorder was caused by my atheism. I didn’t file a complaint because I didn’t want to broadcast that I was bipolar. I nothing against people who have their own beliefs, but, I wonder if evangelicals are trying to bring us back into the dark ages.

  • TEL

    Cary:Many thanks for the last post. I appreciate it. I also hope the physician’s focus is on the patient’s well-being. I actually don’t make any secret about my faith, but I am sensitive to the fact that others have different beliefs, and I hope they share that sensitivity about mine.

  • Athena

    I had outpatient gynecological surgery a few months ago. (No, it was NOT an abortion!) It was at a local Catholic hospital. If my doctor, nurse, anesthesiologist, or even the person taking my insurance information had asked me to pray with them, I would have been dumbfounded and probably would have cancelled the surgery right then and there. Either that, or I would have called upon any number of Goddesses and really blown their little minds. What a lot of evangelical Christians don’t seem to realize is 1) there is a time and place for everything and 2) a lot of people, including Christians, have been raised to not talk about their religion in public. If a doctor wants to pray that the surgery is successful, or pray for my everlasting soul, do it on your own time or silently. Just as I am praying to my Gods silently. I firmly believe that religion should be based on attraction rather than promotion.

  • AnthonyG

    No civilized society would permit fundamentalists to substitute their primitive religious ideology for medical science.Fundamentalists in America already have proven they they will gladly allow young people to contract STDs and HIV-AIDS, rather than violate their politically correct beliefs about condoms; others have allowed infants and children to die rather than obtain medical treatment because the latter violated some religious superstition. If you give these fanatics an inch, they’ll take a mile. We’ll end up like Saudi Arabia where religious police allowed schoolgirls to burn alive rather than leave a burning with their heads uncovered.

  • matt

    A doctor should be able to treat a patient in whatever manor they and the patient see fit. If a certain doctor refuses certain treatments on religious grounds, that is their progative. The patient has a responsibility to find and use a doctor they are comfortable with and that provides the treatments and options they desire. In fact, patients should ‘shop’ doctors and their philosophy of medicine and treatments!Most doctors are in a ‘for profit’ business. If their business is affected negatively because they refuse certain treatments, then that is a choice they must evaluate. I do believe a doctor should be familliar with the options scientifically and express those to patients. But they should not be required to administer any practice that is against their conviction. Forcing them to do otherwise is playing politics and pushing agendas.

  • Kelsey

    I do not care what religion the doctor is when it is a doctor you can choose, and when they post and provide a declarative document that up front states their positions on standard care treatments as regards their religion. Then it is your choice as the patient as to whether you hire that doctor. Of course, that means insurance companies must be able to provide access to doctors of all faiths and beliefs so patients may have choice. This way both patients and doctors can be accomodated. However, doctors who choose to work in emergency care areas where patients have no options to make choices should have no choice but to provide the full breath of standard care, not limited by their personal religious beliefs. If they cannot or will not do that then they should change their specialty or limit their specialty to only those situations where patients can make an informed choice.

  • L. Calligaro

    I agree with Dr. Sloan. If doctors can withhold legal treatments based on religious beliefs, then where does this stop in the professional world? I am 7 months pregnant – when I go to the grocery store and buy wine, to cook with, for my husband, whatever reason – what if the checkout clerk says, “no, I won’t sell this alcohol to a pregnant woman. It’s against my beliefs.” Is the burden then on ME to find a store that will sell it? That’s crazy. I think anyone who accepts a job, especially a state licensed job, should be prepared to carry out all the duties of that job. If their beliefs conflict, then THEY should find another job. I strongly feel that religion and the workplace should be kept separate. People have freedom of religion, of course, but that does not give them the right to practice, in effect, their religion in the workplace.

  • Mark Blumenthal, MD, MPH

    As a Jewish physician, I find it unthinkable that I would attempt to evangelize a patient.

  • Mark Gary Blumenthal, MD, MPH

    As a Jewish physician, I find it unthinkable that I would attempt to evangelize a patient.

  • Mark Gary Blumenthal, MD, MPH

    As a Jewish physician, I find it unthinkable that I would attempt to evangelize a patient.

  • jbe

    EXACTLY!!!DR.s AND PHARMACISTS WHO USE RELIGION IN THEIR WORK ARE CRIMINALS VIOLATING THEIR OATH TO DO NO HARM, ARE HYPOCRITES, ARE IMMORAL, AND ARE CRIMINALS IN WHITE LAB COATS.

  • jbe

    EXACTLY!!!DR.s AND PHARMACISTS WHO USE RELIGION IN THEIR WORK ARE CRIMINALS VIOLATING THEIR OATH TO DO NO HARM, ARE HYPOCRITES, ARE IMMORAL, AND ARE CRIMINALS IN WHITE LAB COATS.

  • cynic

    The Hippocratic oath (from Wikepedia)“ I swear by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses, making them my witnesses, that I will fulfill according to my ability and judgment this oath and this covenant: I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.I will neither give a deadly drug to anybody who asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art.I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work.Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves.What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself, holding such things shameful to be spoken about.If I fulfill this oath and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.”

  • Mom of 5

    “A doctor should be able to treat a patient in whatever manor”"manor” should be “manner”. I hope you’re smarter than you spelling

  • Terra Gazelle

    Priver-I would love to see the look on that doctor’s face if the person being operated on happened to be a Pagan, turned to him and said “ok doc- point my gurney towards North first, then East in a clockwise direction” and then begins to call the corners.lol…terra

  • LP

    Interesting how we don’t read these kids of discussions about the percentage of doctors who take rape and abuse their patients. I bet a quick check of the internet would show the percentage of doctors who refuse treatments upon religions grounds is about the same as those who mistreat their patients in other ways.Should a doctor alert a patient to all possible treatments? Unequivably, yes. Should (s)he perform all treatments dispite personal convictions? No. Just as a politician should not vote againt his/her conscience, a physician should not practice his/her profession against his/her conscience. In the end, we all have to account for our actions. This is true no matter what “religion” you practice – it’s just a matter of when, how, and to whom we account.

  • coprogirl

    Vivi: great story about your mom being confronted by a doctor who was a stranger, who was asking about whether her children were christians. What an agenda! I would have walked out of the room.People who are seeing a doctor are in a vulnerable position. I consider it coercive for a health professional to express religious opinions.I am a nurse for 35 years, and while I respect the religious beliefs of my patients, I would never share my own.

  • Patrick

    When doctors decide to place their beliefs ahead of their patients needs, doctors are being selfish, self oriented, and self absorbed.The doctors in this group are tryign to place their personal beliefs ahead of their patients needs.That is called a hypocrite. Me first than you!Perhaps doctors might pray about whom is actually important, the person collecting payment; doctor; or the person paying the bill; patient.I think the patient deserves the highest respect from the doctor through respecting the patient first and the doctor’s beliefs do not count. it is the patient and thier ills that have brought the tewo together, not religion.Inconsistent attitude. Perhaps these doctors should consider a new profession theology and not medicine.

  • stuart

    Thanks for publishing this piece. I changed dentists recently because I felt my dentist was withholding treatment because of his Mormon convictions. I got a second opinion from another dentist who told me I had a serious dental problem and we went ahead with a treatment plan that included prescriptions my first dentist would not write. Like you said, I think these people should find another career path. What would happen to a vegetarian chef who refused to prepare a porterhouse at a steak restaurant?

  • J Rhinehart

    I certainly agree. I have never known someone who was refused a medical service because of religion. Not overtly. I hope I never meet such a problem. I have recently had a disagreement with my mother’s former physician. We went to another physician. Doctors are not perfect, but as you said, in a relationship between doctor & patient, the doctor still has an authoritative role. That puts a heavier burden on a doctor than on the patient. With greater power comes greater responsibility.

  • PriveR

    Terra:I was hoping there was some room for some levity amongst all the shouting.Glad to be of service. :)That WOULD be something to see, though, wouldn’t it?

  • Michael (the evil fantasy doctor, not the other one)

    Interesting string of posts…and lots of upset folks on both sides of the fence. Soooo many people that think they have a monopoly on the right way to do things.Probably shouldn’t do this, but it could be an interesting exercise. I’ll explain at least how I work things, and see what you all think. Feel free to tell me if you think I’m doing things wrong (and from the above posts, I know you will).A patient comes in to see me in clinic. If I don’t know them, I introduce myself and try to get to know them. Not only do I find out what’s wrong that caused them to come in that day, but I try to find out about their past medical history, medications they are taking, any allergies, family history, and their social history including such things as if they are married, where they work, if wear a seat belt or drink alcohol, etc. I almost never ask about religious habits, but might if they have time, I have time, and something indicates that they may be approachable about such things such as an item of religious jewelry or something. I perform a physical appropriate for the complaint that brought them in, formulate a diagnosis, and present a proposed treatment plan based upon *all* the data I’ve collected up to that point that I believe would be the best option or options for that individual patient. I also use that time if they’re a new patient to explain that I’m more of a collaborative physician—that I believe that they hold the ultimate responsibility for their health care, and that I will do what I can to assist in improving their health, but if they disagree with my recommendations they need to communicate that with me so we can make a plan for treatment that they feel will best work for them. For returning patients that I know, usually this is much abbreviated to a greeting followed by quickly getting to the problem at hand.Of course, all sorts of permutations can arise over time, and with the question being the role of religion here, I’ll get to the point. Usually, religion in my clinic comes up in one of two ways:A) The patient approaches me on the subject. Probably the more common of the two, something is going on in the patient’s life that causes them to reach out to me. Usually the patient simply asks me to pray for or with them. Incidentally, I always agree, regardless of the religion as long as it doesn’t require an action on my part that would violate my personal religion. I find this almost always is quite beneficial to the patient as evidenced by some subjective physical signs such as observing a more relaxed muscle tone or improvement in vocal quality. It also is good for me as well, and has allowed me the opportunity to participate in some activities that I would never otherwise have done. For example, I recently attended a Buddhist ceremony for a patient and her family. I’m not a Buddhist, but it seemed to be a comfort for the family and reassure them that they were not alone in their crisis.Religion has come up one other time that I can recall over the past 12 or so years, and that was just in this past year. A young woman was referred to me for Plan B. I discussed with her the aspects of her health and current situation, and we formulated that the best plan for her was indeed my prescription of Plan B. We went over the precautions, what she should look for, and when and if she needed to follow up. I thought we were done when she asked me point blank why her regular doctor couldn’t take care of her. I told her that I couldn’t honestly say exactly why in her case, but that her regular doctor and I had discussed in general terms his beliefs against Plan B, and that I would be honored to see and care for any of his patients that would require the treatment as I did not have the same beliefs. She asked what did I believe, and I took that as an open invitation to do just that. She left, and seemed to do so with the impression that she had been well cared for. After all, she has become one of my regular patients.All this is to say in short that there are times where medicine and religion mix very well to the overall benefit of the patient as a whole person, and a member of a family and community. To ignore religion as an aspect of the whole person is as wrong as a neurologist who ignored the heart.

  • Anonymous

    TO DR MICHAEL, To me, it’s every doctor’s responsibility to take care of the whole person, not just one part of him.

  • TEL

    Michael:Well said! I think that sort of collaborative interaction, which takes into account all sources of support for a patient to be logical, and really puts the patient first. It’s similar to how I was trained when I did case management work at a domestic violence shelter (and other non-profit work). I also found many of my clients drew strength from their beliefs, and it was helpful for them to be able to talk about it (and to feel free to pray).A collaborative relationship is always something I look for from a doctor. After all, much of what dictates my own health is how well I take care of myself (exercise, diet, stress management), how well I communicate my concerns to my doctor, and how well I follow my doctor’s advice.

  • Richard

    In America, we have the right to believe whatever we choose concerning gods and religion. However, this freedom does not guarantee the right of respect.We show no respect to those who deny the holocaust or call psychic hot-lines. So why treat irrational religious belief any different?When it comes to medicine, for God’s sake (pun intended) we need to demand logic and reason.For far to long, people of reason, have tried to peacefully coexist with people of faith. However, the “faithful” are not content to keep it to themselves.Richard

  • Richard

    In America, we have the right to believe whatever we choose concerning gods and religion. However, this freedom does not guarantee the right of respect.We show no respect to those who deny the holocaust or call psychic hot-lines. So why treat irrational religious belief any different?When it comes to medicine, for God’s sake (pun intended) we need to demand logic and reason.For far to long, people of reason, have tried to peacefully coexist with people of faith. However, the “faithful” are not content to keep it to themselves.Richard

  • Meri

    Dr. Micahael,Thank you for weighing in on this. I find it especially helpful to know that there are doctors who care about this issue other than the ones who wish to force their religion upon their patients’ medical care. Were I in your care, I would find your approach entirely appropriate, and, in fact, you sound very much like my current doctor. I find no problem with integrating spiritual aspects into medical care so long as it is for the benefit of the patient and, most importantly, with the patient’s informed acknoledgement that they find it appropriate for their care. Also, just as I find it completely inappropriate for a doctor to withhold treatments from their patients for religious reasons, I would find it just as inappropriate for a doctor to insist upon a treatment that the patient found morally repugnant, after that patient had declined that course of action. In the end, the entire point behind the doctor-patient relationship is to benefit the patient’s health, not to secure a place in heaven for the doctor’s soul.

  • victoria

    moderate- i searched the us national library of medicine (the largest resource in the world) and found no evidence that galen started the first hospital- however- no one questions or denies his incredible impact on the world- he was certainly a surgeon- heres a link to the development of hospitals by muslims in the world- by te same source- i look forward to reading any links you provide peace

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