Religious Factors

Religion, Culture, and Values

Defining what counts as a religious factor in decision making is not simple. There is no generally agreed-on definition of religion; for instance, not all religions have deities. Furthermore, in specific cases there is frequently no simple way of separating religious factors from cultural factors, because the same religion has developed different traditions in different geographical regions and in different societies.

In the case of the major scriptural religions, three or sometimes four elements come together to determine the beliefs and practices of adherents:

• 1.
  The original revelation in the form of the scriptures, that is, the writings held to be authoritative
• 2.
  The tradition
• 3.
  Reason
• 4.
  In some instances, ongoing revelation

The balance between the three sources of religious guidance differ between religions and often also within religions in relation to different areas of belief. The scriptural revelation is furthermore being continuously (re)interpreted through reason, but this always takes place through the lens of a particular tradition, and that tradition may also decide who is seen as competent to perform the interpretation. This means that it will often be important to know which particular branch of a given religion a patient identifies with because (a) the religious beliefs and values may differ between different branches and (b) the patient may be more responsive to advice from his or her “own” religious leader than from someone representing another branch of what to the outsider looks like the same faith community.

The fact that a particular view is religious is not in itself a reason to respect it or accord it more weight. Religious views are not by the mere fact that they are religious intrinsically worthy of respect. But religious identification is often part of a person's core identity, and there are good reasons to treat core beliefs differently than beliefs that the person in question sees as peripheral.

Religion and Patients

Religious factors often play a significant role in the decision making of patients, especially in cases where being a member of a particular faith community is part of the patient's core identity. This may lead a person to aim at particular treatment goals and choose or refuse particular treatment modalities. A Muslim couple seeking in vitro fertilization may, for instance, have religious objections to any use of donor gametes but no objection to the creation of embryos and selection among embryos created with their own gametes.

It is generally accepted in the law of most jurisdictions that an adult person can refuse any kind of treatment even if that treatment is likely to be lifesaving. Healthcare professionals have been slightly slower to accept this, but it is now widely accepted that, for instance, an adult member of Jehovah's Witnesses should be allowed to refuse even a potentially lifesaving blood transfusion.

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