More end-of-life-care info, STAT!

There was an interesting Associated Press story out of London the other day about end-of-life issues that has really been making the rounds -- for perfectly valid reasons. Most of all, the story left me wondering if anyone on this side of the Atlantic has done similar research. Here's the top of the story, as it appeared in the Washington Post:

LONDON -- Doctors who are atheist or agnostic are twice as likely to make decisions that could end the lives of their terminally ill patients, compared to doctors who are very religious, according to a new study in Britain.

Dr. Clive Seale, a professor at Barts and the London School of Medicine and Dentistry, conducted a random mail survey of more than 3,700 doctors across Britain, of whom 2,923 reported on how they took care of their last terminal patient. Many of the doctors surveyed were neurologists, doctors specializing in the care of the elderly, and palliative care, though other specialists like family doctors, were also included.

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.

That's powerful stuff.

However, veteran religion-beat Cathy Lynn Grossman of USA Today had a perfectly logical reaction to the angle taken in this wire-service report. She wondered, in effect, if anyone had thought to flip the story backwards. Here's the passage that caught her attention:

To ensure doctors are acting in accordance with their patients' wishes, Seale wrote that "nonreligious doctors should confess their predilections to their patients." Seale also found that doctors who were religious were much less likely to have talked about end of life treatment decisions with their patients.

According to guidelines from the British Medical Association, doctors must not allow their religious beliefs to interfere with their treatment of patients.

Thus, Grossman asked the following in a post at her Faith & Reason weblog:

Which is the grabber headline here?

Nonreligious British physicians let -- or lead - their severely ill patients die earlier than religious docs do.

Or ...

Religious British physicians may prolong dying patients pain.

Associated Press led with the first concept, but is the real story the second one?

That's a great question and Grossman asked several more. For example, did the study contain any information about whether these irreligious doctors were or were not following the expressed wishes of their patients? Here's another one: Is there any way to know how many religious doctors were acting without discussing with their patients the relevant end-of-life-care issues? What percentage?

Now, I realize this was a short news story about a hellishly complex topic and, frankly, it raised more questions than it answered.

However, I couldn't help but ponder another question. Anyone who knows anything about the history of the hospice-care moment knows that religious groups -- especially Catholic groups -- have played major roles in the development of this kind of compassionate care, which stresses the relief of pain as patients proceed towards natural death. (Here's a recent Scripps Howard column of mine on a topic related to that.)

When it comes to leadership by religious groups, Catholics are not alone in their concern about patients and clergy working with doctors in the preparation of these kinds of end-of-life directives.

So, who are these "very religious" doctors who are less likely to discuss these kinds of questions with patients (and one would assume their families and clergy)? What traditions do they represent? What churches? This is a case in which you just know that there are subgroups inside that terribly vague umbrella term, just as there are sure to be complex clusters of doctors under the "atheist" and "agnostic" terms.

But one thing is for sure. This study is fascinating and disturbing and points toward important news topics (plural), especially in the United States in which (here's an understatement) there are probably more doctors in pews every weekend than there are in the UK.

More information, please. Pronto.

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