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Religious and Spiritual Beliefs of Gynecologic Oncologists May Influence Medical Decision Making
  1. Lois Ramondetta, MD*,
  2. Alaina Brown, MD,
  3. Gwyn Richardson, MD,
  4. Diana Urbauer, MS§,
  5. Premal H. Thaker, MD,
  6. Harold G. Koenig, MD,
  7. Jacalyn B. Gano, MSW* and
  8. Charlotte Sun, DrPH*
  1. *Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX;
  2. Department of Obstetrics and Gynecology, The John Hopkins Hospital, Baltimore, MD;
  3. Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX;
  4. §Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX;
  5. Department of Obstetrics and Gynecologic Oncology, Washington University School of Medicine in St. Louis, St. Louis, MO; and
  6. Department of Psychiatry, Duke University Medical Center, Durham, NC.
  1. Address correspondence and reprint requests to Lois M. Ramondetta, MD, Department of Gynecologic Oncology, Unit 1362, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030. E-mail: lramonde{at}mdanderson.org.

Abstract

Background Religious (R) and spiritual (S) beliefs often affect patients' health care decisions, particularly with regard to care at the end of life. Furthermore, patients desire more R/S involvement by the medical community; however, physicians typically do not incorporate R/S assessment into medical interviews with patients. The effects of physicians' R/S beliefs on willingness to participate in controversial clinical practices such as medical abortions and physician-assisted suicide has been evaluated, but how a physician's R/S beliefs may affect other medical decision-making is unclear.

Methods Using SurveyMonkey, an online survey tool, we surveyed 1972 members of the International Gynecologic Oncologists Society and the Society of Gynecologic Oncologists to determine the R/S characteristics of gynecologic oncologists and whether their R/S beliefs affected their clinical practice. Demographics, religiosity, and spirituality data were collected. Physicians were also asked to evaluate 5 complex case scenarios.

Results Two hundred seventy-three (14%) physicians responded. Sixty percent "agreed" or "somewhat agreed" that their R/S beliefs were a source of personal comfort. Forty-five percent reported that their R/S beliefs ("sometimes," "frequently," or "always") play a role in the medical options they offered patients, but only 34% "frequently" or "always" take a R/S history from patients. Interestingly, 90% reported that they consider patients' R/S beliefs when discussing end-of-life issues. Responses to case scenarios largely differed by years of experience, although age and R/S beliefs also had influence.

Conclusions Our results suggest that gynecologic oncologists' R/S beliefs may affect patient care but that most physicians fail to take an R/S history from their patients. More work needs to be done to evaluate possible barriers that prevent physicians from taking a spiritual history and engaging in discussions over these matters with patients.

  • Religion
  • Spirituality
  • Gynecologic oncology
  • Mentorship
  • Spiritual history
  • Medical decision making

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Footnotes

  • The authors have no conflicts of interest to disclose.

  • This research is supported in part by the National Institutes of Health through MD Anderson Cancer Center Support Grant CA016672.

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