How honest is your doctor when it comes to controversial issues?

If the latest research is to be believed patients will not necessarily receive the complete truth from their doctor.

According to a new study some doctors apparently consider it perfectly acceptable to withhold information regarding issues such as birth control, abortion and sedating dying patients, and even more of the medical profession feel under no obligation to tell patients where or how they access such advice or care.

In a survey of doctors conducted by researchers at the University of Chicago, of the 1,144 American doctors who responded to the poll, although most supported full disclosure and referral to another health care provider if they had moral objections to a treatment or procedure, many did not.

The researchers say the medical profession seems to be divided in its attitudes about providing controversial practices such as terminal sedation, abortion or birth control for teens, but also in its judgments about what doctors should do when patients request a legal procedure to which their doctor objects.

Dr. Farr Curlin, assistant professor of medicine and a member of the MacLean Center for Clinical Medical Ethics at the University, says the study found that although 86 percent of doctors did feel obliged to present all options in such cases, only 71 percent said they would feel obligated to refer the patient to a doctor who did not object to the requested procedure, and 63 percent believed it is ethically permissible for a doctor to describe his or her objection to the patient.

Dr. Curlin, says if doctors ideas translate into their practices, then 14% of patients (more than 40 million Americans) may be cared for by physicians who do not believe they are obligated to disclose information about medically available treatments they consider objectionable.

Another 29% of patients (almost 100 million Americans) may be cared for by physicians who do not believe they have any obligation to refer the patient to another provider for such treatments.

The study revealed that male doctors, Christian doctors, particularly Catholics and Protestants, and doctors with the strongest religious beliefs were most likely to say it is permissible to withhold information and not help a patient find another source of controversial care.

Dr. Curlin says the findings suggest that should a patient need to access an area of medical treatment that may be controversial, a frank conversation with their physician might be a pre-requisite step.

The researchers mailed a 12-page questionnaire to 2,000 doctors from all specialties and asked them if they had objections to three controversial clinical practices.

They also asked physicians about their sense of obligation when patients request such procedures.

Only 17 percent objected to terminal sedation, but 42 percent objected to prescription of birth control to teenagers without parental consent, and 52 percent objected to abortion for failed contraception.

The survey say the researchers exposes a basic dilemma facing patients and physicians who may come from many different moral traditions, both religious and secular, and they will sometimes disagree about whether a particular medical intervention is morally permissible.

The researchers say although a few doctors thought patients had no right to expect morally objectionable treatments, others thought that doctors who would deny beneficial treatments had no business practicing medicine.

But most doctors felt they had the right to follow their conscience, and patients had a right to legal, medically approved treatment which say the authors places much of the burden onto patients.