A case study published in the AMA Journal of Ethics reviewed the ethical dilemmas posed by a patient’s request for prayer before a scheduled bypass surgery.

April R. Christensen, MD, of the division of general internal medicine, department of medicine, University of Pittsburgh Medical Center in Pennsylvania, and colleagues, reviewed the case. The surgeon in question is a secular Jew and atheist who felt uncomfortable when the patient, a devout Catholic, requested that she pray with her. The surgeon suggested calling the chaplain, and the patient felt rebuffed.

Dr Christensen and colleagues suggested that rather than immediately trying to deflect the patient’s request, a physician should pause to internally examine why the request makes them uncomfortable and their own emotional response to the request. The investigators also noted that there are ways to deal with this situation that both honor a patient’s faith and maintain a physician’s boundaries. 

The researchers suggested that physicians might explore the reason behind a patient’s request for prayer. In the case study presented, the patient is facing major surgery, and may be frightened and feeling alone and vulnerable. She has little control over the situation, and prayer can be an important coping mechanism. Alternatively, the patient may want to know that the clinician is a believer.

Dr Christensen and colleagues proposed that when faced with such requests, physicians should take the time to understand their patients’ concerns. When responding to a patient’s request, a physician should not lie about their own beliefs, but focus on the psychological basis of the patient’s request for the physician’s presence during prayer. 

In the case study, despite the physician’s atheism, she could acknowledge the importance of faith to the patient and reassure her that she will keep her in her thoughts and do everything she can for her. Or she could suggest spending a few moments of silence together.

If a patient persists in trying to find out if their physician prays, the physician could again acknowledge the importance of the patient’s faith and offer to stay with them while they pray.

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The investigators caution, however, that even when both patient and physician share the same faith, praying silently together may be better than praying aloud because differences in beliefs within the same faith could distress the patient. If asked to lead a prayer, the physician could ask God for support and to be present for the patient during the surgery.

While the decision of whether or not to pray with a patient is a personal one, introspection can help physicians offer a carefully considered response that acknowledges and explores a patient’s request.

Reference

Christensen AR, Cook TE, Arnold RM. Case with commentary. How should clinicians respond to requests from patients to participate in prayer? AMA J Ethics. 2018;20:E621-E629.