Physician values and medical decisions.

To the Editor: Neumann and Olive (1) surveyed a national sample of family practitioners and psychiatrists. Family practitioners were generally more supportive of religious activities than psychiatrists. This letter reports further analyses of this survey data set, in order to assess the extent to which specific self-identified religious values affected medical decisions and lifestyle factors, similar to assessments performed in other, previously published work. (2) Family physician versus psychiatrist group differences concerning these variables were minimal, and are not further considered in this letter.

This data set was analyzed as a function of the five most common self-identified value groups. From 316 respondents, groups were identified as follows: Liberal Protestants (LP, n = 52), Conservative Protestants (CP, n = 53), Liberal Catholics (LC n = 44), Liberal Jews (LJ, n = 27), and Spiritual Humanists (SH, n = 29). Each value label had a brief descriptive statement. Respondents completed a 19-item questionnaire requesting demographic, health habit, and religious activity information. Respondents also provided approval ratings of three ethically sensitive vignettes used in previous research (1,3) concerning birth control medication for sexually active single women, euthanasia, and abortion. Data were primarily analyzed by analyses of covariance with Newman-Keuls post-comparison analyses to determine significant differences among the groups.

Minimal demographic differences were found. In terms of health habits, cigarette use varied (F = 3.21, P = 0.014) with SHs smoking more than others. CPs evidenced higher commitment to religious activities than other groups (eg, worship attendance, F = 20.14, P < 0.001; financial giving, F = 58.80, P < 0.001). SHs were more dissimilar to parental values than CPs, LPs, LCs, and LJs (fathers, F = 5.65, P < 0.001; mothers, F = 4.92, P < 0.001). CPs were less approving of birth control (F = 9.66, P < 0.001), euthanasia (F = 18.63, P < 0.001), and abortion (F = 27.97, P < 0.001) than other groups, especially LJs and SHs. Age was a notable covariant in the birth control and abortion vignette analyses; older respondents tended to be more approving than their younger counter-parts. More detail concerning the study may be obtained by contacting Joseph K. Neumann, PhD.

Results confirmed previous research, with CPs being less approving of birth control medications for sexually active single women, euthanasia, and elective abortion. The SH group strongly approved the euthanasia vignette. In clinical settings, patients with non-Christian values desiring euthanasia may find themselves in serious conflict with Christian health providers who do not approve of such procedures. Ethically sensitive decisions by physicians involve a personal awareness and openness to their own values and an acknowledgment that their beliefs impact upon clinical, educational, and administrative decisions.

Acknowledgments

This project was supported by resources from the James H. Quillen Veterans Affairs Medical Center and College of Medicine, Johnson City, TN. The assistance of Mrs. Earnestine Stewart and Mr. David Paul Roberts is gratefully acknowledged.

References

1. Neumann JK, Olive KE. Absolute versus relative values: effects on family practitioners and psychiatrists. South Med J 2003;96:452-457.

2. Neumann JK, Leppien FV. Influence of physician's religious values on inservice training decisions. J Psychol Theol 1999;25:427-436.

3. Neumann JK, Olive KE, McVeigh SD. Absolute vs. relative values: effects on medical decisions and personality of patients and physicians. South Med J 1999;92:871-876.

Joseph K. Neumann, PHD

Kenneth E. Olive, MD

Department of Internal Medicine

James H. Quillen College of Medicine

East Tennessee State University 

Johnson City, TN

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