REQUESTS FOR INAPPROPRIATE TREATMENT BASED ON RELIGIOUS BELIEFS

Requests by patients or their families for treatment which the patient 's physician considers to be ''inappropriate'' are becoming more frequ ent than refusals of treatment which the physician considers appropria te. Such requests are often based on the patient's religious beliefs a bout the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationsh ip with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith traditions as they relate to such requests. We suggest that rel igious reasons for requesting ''inappropriate'' treatment are ''specia l'' and deserve serious consideration. We offer guidance to assist cli nicians and clinical ethicists as they attempt to resolve these confli cts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these reque sts. We also suggest that clinicians use additional religious doctrine s or principles from patients' own traditions to balance the reasons b ehind the requests. We conclude that most persistent requests for ''in appropriate'' treatment should be honoured.