nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
See here for more discussion.

Friday, August 27, 2010

Non-Religious Doctors More Likely To Provide Life-Ending Care...And?

Admonitions by British ethicists that doctors who aren't religious should make this known to their patients sound off-target to me.

A Brtish study published in the Journal of Medical Ethics (Aug 25), surveryed about 3000 doctors in the UK about their last patient who died.  As described by Assoc Press (Aug 26)
"Doctors who described themselves as "extremely" or "very nonreligious" were nearly twice as likely to report having made decisions like providing continuous deep sedation, which could accelerate a patient's death....Seale [lead author] also found that doctors who were religious were much less likely to have talked about end of life treatment decisions with their patients."
Does this sound like a meaningful addition to our knowledge of end-of-life care?  My experience of world religion is not extensive, but those western religions to which I have been exposed make it an article of faith that God's children are here for a purpose and that He will determine when it is time for them to depart this vale of tears.

So, is it real surprising that atheist doctors don't buy into the "He will determine" part?

This research didn't twang my guitar string.  It certainly didn't lead me to think that
To ensure doctors are acting in accordance with their patients' wishes, Seale [the lead author]wrote that "nonreligious doctors should confess their predilections to their patients."
Nothing in this study said that non-religious doctors pushed end-of-life decisions more frequently, or advised patients to lean toward early termination criteria.  If they did that it would be something to worry about.  But, just acceding to patients wishes more frequently doesn't sound very important...unless you're in the market for someone who will help you end it all.

If you want a Nature Note to remember from this research (also fairly worthless) try this (from the abstract),
Specialists in care of the elderly were somewhat more likely to be Hindu or Muslim than other doctors; palliative care specialists were somewhat more likely to be Christian, religious and ‘white’ than others. Ethnicity was largely unrelated to rates of reporting ethically controversial decisions.
Here are the skimpy data, for Onion Peelers,
A postal survey of 3733 UK medical practitioners, of whom 2923 reported on the care of their last patient who died. Independently of speciality, doctors who described themselves as non-religious were more likely than others to report having given continuous deep sedation until death, having taken decisions they expected or partly intended to end life, and to have discussed these decisions with patients judged to have the capacity to participate in discussions.

Under the US House HCR bill, doctors must discuss end-of-life plans with their patients over 65...unless this got removed from the original 2700 page bill...who knows?  We had to "pass it to know what's in it", right?

Doc D

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