When illness strikes, many people turn to prayer. Often, faith and medicine can go hand in hand. Religion provides comfort and strength, while conventional medicine does its part to restore health. And some recoveries are difficult to attribute to medicine alone.

But what happens when faith and medicine conflict? What do physicians do when a patient’s religious beliefs get in the way of his or her best medical advice? Despite ongoing discussions and debates about what physicians should do in these situations, little is known about what physicians actually do when there is such a conflict.

In the January 10, 2005 Archives of Internal Medicine , scientists examined the ways in which physicians perceive and respond to conflicts between religion and medicine. They found that most physicians encountered a variety of conflicts, and that they tried to persuade or negotiate with patients, while respecting their patients’ religious beliefs—to a point.

About the Study

The researchers conducted in-depth interviews with 21 physicians representing a range of religious backgrounds, including Christianity, Judaism, Buddhism, and Hinduism. Seven of the doctors had no religious affiliation.

The physicians were asked open-ended questions designed to elicit their views on the relationship between religion and health, how they approach conflicts between religion and medicine with their patients, and how their own religious beliefs or value systems shape their practice of medicine.

The Findings

The physicians responded that most disagreements between medicine and religion fell into one of three categories:

  1. A clear religious doctrine conflicts with an otherwise well-accepted medical treatment. For example, Jehovah’s Witness patients refuse blood transfusions . Physicians were least frustrated by this type of conflict, in which the patient clearly understands the situation, but still chooses a particular course of action.
  2. The conflict is not a clear-cut disagreement between medical science and religion, but rather a conflict between value systems of the doctor and the patient. These types of conflicts often involve prenatal or end-of-life issues in which members of certain religious communities believe that life in any form is better than death under any circumstance.
  3. Though the patient has no moral objection to medical treatment, he or she chooses instead to leave things “in God’s hands.” Physicians appeared most frustrated by this type of conflict, in which patients chose to rely solely on faith and prayer despite the availability of effective treatment.

Overall, when there was a conflict between religion and medicine, most of the doctors were prepared to accept their patients’ “bad” choices. However, once the physicians felt that the religious belief could cause the patient overt harm, they responded with one of three strategies:

  1. The physician attempted to get the patient to see their religious practices and beliefs as a complement to medicine, rather than a substitute for it.
  2. The physician tried to negotiate with the patient, within the framework of the patient’s religious beliefs. For example, a physician would encourage the patient to see the physician and medical therapy as something provided by God.
  3. If negotiation with the patient was not successful, the physician might try to appeal to members of the patient’s religious community such as family or clergy.

Finally, if none of these strategies worked, physicians would sometimes refer the patient to another doctor.

How Does This Affect You?

When confronted by illness, faith and prayer can be an invaluable source of comfort. The problem arises when faith and medicine conflict. This study showed that physicians try to respect a patient’s beliefs and autonomy unless they believe a patient’s religious views will result in irreversible harm.

Physician recommendations are never purely objective. As this study's authors point out, science tells patients what they can do; once a physician tells a patient what he or she should do, the physician is introducing his or her own values into the discussion.

In the end, every person competent to make a decision has the right to decide their own destiny. The physician’s responsibility is to clearly explain the consequences of medical action—and inaction—to their patients, make every effort at persuasion, and then allow their informed patients to determine their own fate.