Conscientious refusals to refer: Findings from a national physician survey

Michael P. Combs, Ryan M. Antiel, Jon C Tilburt, Paul Mueller, Farr A. Curlin

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Regarding controversial medical services, many have argued that if physicians cannot in good conscience provide a legal medical intervention for which a patient is a candidate, they should refer the requesting patient to an accommodating provider. This study examines what US physicians think a doctor is obligated to do when the doctor thinks it would be immoral to provide a referral. Method: The authors conducted a cross-sectional survey of a random sample of 2000 US physicians from all specialties. The primary criterion variable was agreement that physicians have a professional obligation to refer patients for all legal medical services for which the patients are candidates, even if the physician believes that such a referral is immoral. Results: Of 1895 eligible physicians, 1032 (55%) responded. 57% of physicians agreed that doctors must refer patients regardless of whether or not the doctor believes the referral itself is immoral. Holding this opinion was independently associated with being more theologically pluralistic, describing oneself as sociopolitically liberal, and indicating that respect for patient autonomy is the most important bioethical principle in one's practice (multivariable ORs, 1.6-2.4). Conclusions: Physicians are divided about a professional obligation to refer when the physician believes that referral itself is immoral. These data suggest there is no uncontroversial way to resolve conflicts posed when patients request interventions that their physicians cannot in good conscience provide.

Original languageEnglish (US)
Pages (from-to)397-401
Number of pages5
JournalJournal of Medical Ethics
Volume37
Issue number7
DOIs
StatePublished - Jul 2011

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physician
Physicians
Referral and Consultation
medical services
conscience
obligation
candidacy
Surveys and Questionnaires
random sample
respect
Cross-Sectional Studies
autonomy
Doctors

ASJC Scopus subject areas

  • Health Policy
  • Health(social science)
  • Issues, ethics and legal aspects

Cite this

Conscientious refusals to refer : Findings from a national physician survey. / Combs, Michael P.; Antiel, Ryan M.; Tilburt, Jon C; Mueller, Paul; Curlin, Farr A.

In: Journal of Medical Ethics, Vol. 37, No. 7, 07.2011, p. 397-401.

Research output: Contribution to journalArticle

Combs, Michael P. ; Antiel, Ryan M. ; Tilburt, Jon C ; Mueller, Paul ; Curlin, Farr A. / Conscientious refusals to refer : Findings from a national physician survey. In: Journal of Medical Ethics. 2011 ; Vol. 37, No. 7. pp. 397-401.
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