What is the impact of religion on end-of-life care decisions, and how should clinicians approach conversations about goals of care?

• A. End-of-life decisions should be based solely on medical prognosis, ignoring religion.
• B. Religion heavily shapes decisions about DNR, hospice, and treatments; clinicians should discuss goals, ensure informed consent, involve family and chaplaincy, respect beliefs.
• C. Religion has no impact on decisions.
• D. Clinicians should respect beliefs but not involve chaplaincy.

Answer: (B)

Religion often shapes what patients consider a meaningful outcome at the end of life, which treatments align with their values, and how they weigh burdens versus benefits. The best approach for clinicians is to open a clear goals-of-care conversation that invites the patient (and family, if appropriate) to share how their beliefs influence decisions about resuscitation, hospice, and other treatments. This means outlining medical options and their risks in plain terms, confirming what matters most to the patient, and ensuring informed consent that aligns with those beliefs.

Involving spiritual care resources, such as chaplains, is an important part of supporting this process. Chaplaincy can help address spiritual distress, clarify beliefs, and provide support to both patients and families as decisions are made. Respecting beliefs while keeping the medical reality in view helps prevent discord between care provided and patient values, and supports decisions that are truly patient-centered.

While clinicians should respect religious diversity and preferences, choices should be guided by the patient’s values and supported by appropriate resources. Ignoring religion or excluding spiritual care can lead to care that doesn’t reflect what matters most to the patient, increasing the risk of goals of care not being met.