Capsule Commentary on Putman et al., Directive Counsel and Morally Controversial Medical Decision-Making: Findings from Two National Surveys of Primary Care Physicians

Excerpt

Putman et al.1 utilized two independent cross-sectional surveys to investigate whether primary care providers (PCPs) are less likely to endorse directive counsel for “morally controversial” medical decisions compared to typical ones. The first survey asked abstractly about directive counseling, and found that physicians were less likely (35 % vs. 65 %) to endorse directive counseling for morally controversial than typical decisions. The second survey included a clinical vignette of a patient requesting palliative sedation; in this case, 41 % of providers endorsed directive counsel, while 51 % endorsed avoiding influencing the patient’s decision. Physicians were more likely to endorse directive counseling if the physician attended religious services, considered religion to be fairly or mostly important, or were less theologically pluralistic. It is interesting to note that the gap narrowed from the abstract question about morally controversial decision to a more concrete clinical vignette. …