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Conflict Between Religious Convictions and Clinical Judgment

Allan S. Brett, MD; Paul Jersild, ThD

Arch Intern Med. 2003;163:1645-1649.

Not infrequently, Christian patients and families provide religious justifications for an insistence on aggressive medical care near the end of life. Four commonly invoked reasons are (1) hope for a miracle, (2) refusal to give up on the God of faith, (3) a conviction that every moment of life is a gift from God and is worth preserving at any cost, and (4) a belief that suffering can have redemptive value. For each of these 4 reasons, however, there are alternative Christian interpretations that point in the direction of limiting medical intervention under certain circumstances. When clinicians believe that an intervention is medically inappropriate or inhumane, they are not necessarily obligated to provide it simply because it is demanded on religious grounds. Instead, clinicians—preferably assisted by chaplains or clergy—should discuss alternative religious interpretations with the patient or family, and should attempt to reach a consensus on the appropriate limits to life-sustaining treatment.

From the Center for Bioethics and Medical Humanities, University of South Carolina (Drs Brett and Jersild), and the Department of Medicine, University of South Carolina School of Medicine (Dr Brett), Columbia. The authors have no relevant financial interest in this article.

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