Religion and spirituality: Barrier and bridge to medical care

Pediatricians and pediatric oncologists express differing views on religion and spirituality, largely based on the types of patients they treat, according to a survey that will appear in the current edition of the journal Social Problems.

Elaine Howard Ecklund, assistant professor of sociology and associate director of the Center on Race, Religion and Urban Life at Rice University, is a co-author of the study, which is based on in-depth interviews with 30 doctors who practice and teach at elite medical centers around the United States. The other authors are Wendy Cadge of Brandeis University and Nicholas Short of Baylor College of Medicine.

The study focused on two questions: "How do pediatric physicians gather information about religion and spirituality in their work with patients and families and describe when, if at all, that information is relevant to their professional work? Second, as they negotiate professional boundaries around religion and spirituality in everyday interactions with patients and families, do they perceive religion and spirituality to be a barrier or a bridge to medical care?"

The research found "that pediatric oncologists are more likely than the pediatricians interviewed to see the religion or spirituality of patients as relevant to their professional jurisdictions." Moreover, "the majority of the physicians interviewed see religion and spirituality as most relevant in difficult medical decision-making situations, in particular those made about end of life care."

The researchers conclude that overall, the physicians in the survey "see religion and spirituality as both a barrier and a bridge to medical care. Physicians think it is a barrier when it impedes their work and/or care for children, especially care for children who are Jehovah's Witnesses, Orthodox Jews, or members of religious traditions that have existed in some tension with biomedicine. It is a bridge when it helps patients and families make sense of illness, adjust to difficult news, and answer questions that medicine inherently cannot."

The survey's data were gathered through lengthy interviews with 30 randomly selected pediatric physicians (14 pediatricians and 16 pediatric oncologists) at top U.S. teaching hospitals, including Stanford Hospital and Clinics, The Johns Hopkins Children's Center, UCLA Medical Center, the University of Michigan Medical Center, Duke University Medical Center, University of Washington Medical Center, Mayo Clinic, Cleveland Clinic, New York-Presbyterian Medical Center, Massachusetts General Hospital, Hospital of the University of Pennsylvania, University of California San Francisco Medical Center and Barnes-Jewish Hospital.