1 out of 7 doctors put morals ahead of medicine

Many doctors feel they have no ethical obligation to inform patients about controversial medical practices or to make referrals to doctors who think differently, according to a survey of physicians by University of Chicago researchers.

The survey found that about 1 in 7 U.S. doctors believes in withholding information on moral grounds about treatments such as abortion, terminal sedation for the dying and prescribing birth control to adolescents.

Nearly one-third believe it is ethical to refuse to refer a patient seeking such treatments.

The survey results suggest patients who might want controversial treatments should educate themselves about medical options and choose their doctors accordingly, said Dr. Farr A. Curlin, lead author of the study, published today in the New England Journal of Medicine.

“If patients don’t know what their doctors’ stances are,” he said, “they might want to ask.”

Curlin said there is long-running debate among doctors over the extent to which physicians’ personal beliefs should play a role in their practice.

Dr. Gary Smith, an obstetrician and gynecologist at the Women’s Health Center at Robinwood in Hagerstown, Md., said he is opposed to abortion and emergency contraception.

Smith, who indicated he is religious, does not perform abortions or refer patients to another doctor who will.

He also refuses to prescribe emergency contraceptive pills such as Plan B, which he considers tantamount to abortion.

“I was always taught I have two patients, the mother and the baby,” he said. “Why would I want to send somebody out to hurt their baby?”

The survey was mailed to a random sample of U.S. doctors in various medical specialties in 2003 and drew 1,144 responses.

More than half reported objections to performing abortions when the pregnancy resulted from failed contraception.

And more than 40 percent said they objected to prescribing contraception for adolescents without parental consent.