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Decisions on end-of-life care ‘heavily influenced by GPs’ religious beliefs’

By Lilian Anekwe

GPs who are ‘very or extremely non-religious' are more likely to take ethically controversial decisions when providing end-of-life care for patients, according to a study by UK researchers.

A survey of three thousand doctors of different disciplines – including more than 1,000 GPs – found that strengths of religious beliefs did influence the decisions taken by doctors looking after patients approaching the end of their life.

The research came as the Government called on the NHS to ‘redouble its efforts' on end-of-life care in its second annual report.

Researchers received completed postal questionnaires from nearly 1,113 UK GPs, 311 palliative care specialist, 402 geriatricians, 190 neurologists and 1,700 other hospital consultants.

Along with details of their ethnicity and religious beliefs, all doctors were asked for responses to four questions: whether they supported the legalisation of assisted dying, whether they had ever provided continuous deep sedation until a patient's death, whether they had knowingly taken a decision that had hastened the end of a patient's life, and whether in taking that decision they had discussed it with the patient beforehand.

14% of GPs described themselves as very or extremely religious, while 68% said they were either not religious at all, or only mildly so. 18% said they were very or extremely religious.

Compared to the reference group of palliative care specialists, GPs were four times more likely to have taken a decision that they knew would hasten a patient's death, and four times more likely to back a change in the law on assisted dying.

Professor Clive Seale, professor of medical sociology at Queen Mary University of London, concluded in the Journal of Medical Ethics: ‘In multivariate analysis, being very or extremely non-religious increases the odds of a doctor reporting sedation or a decision with some intent to end life regardless of speciality.

Professor Seale said: ‘Religion plays a quite a big part in influencing what GPs think and do when they are dealing with end of life care decisions.

‘You would expect that GPs respond to clinical factors but their own values come into play in quite a big way. If I were a patient approaching the end of my life, I would want a discussion about religious views with my GP.'

The Government has pledged a further £40 million to support patients' choice of end-of-life setting. Care Services Minister Paul Burstow said: ‘We need to ensure that the care people receive at the end of life is compassionate, appropriate and gives people choices in where they die and how they are cared for.

‘While there has been good progress made so far this year the variation in progress across the country means the NHS must redouble its efforts. That is why more work will be done to improve training, promote best practice and make sure good end-of-life care is embedded across the NHS.'

Journal of Medical Ethics published online 25 August 2010.

GP's religious belief 'influences their decisions in end-of-life care'

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