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Importance of Faith on Medical Decisions Regarding Cancer Care

Gerard A. Silvestri, Sommer Knittig, James S. Zoller, Paul J. Nietert

From the Department of Medicine and Center for Health Care Research, Medical University of South Carolina, Charleston, SC.

Address reprint requests to Gerard A. Silvestri, MD, MS, Associate Professor of Medicine, Medical University of South Carolina, 96 Jonathan Lucas St, Ste 812 CSB, P.O. Box 250623, Charleston, SC 29425; email: Silvestri{at}musc.edu.

Purpose: Decisions regarding cancer treatment choices can be difficult. Several factors may influence the decision to undergo treatment. One poorly understood factor is the influence of a patient’s faith on how they make medical decisions. We compared the importance of faith on treatment decisions among doctors, patients, and patient caregivers.

Methods: One hundred patients with advanced lung cancer, their caregivers, and 257 medical oncologists were interviewed. Participants were asked to rank the importance of the following factors that might influence treatment decisions: cancer doctor’s recommendation, faith in God, ability of treatment to cure disease, side effects, family doctor’s recommendation, spouse’s recommendation, and children’s recommendation.

Results: All three groups ranked the oncologist’s recommendation as most important. Patients and caregivers ranked faith in God second, whereas physicians placed it last (P < .0001). Patients who placed a high priority on faith in God had less formal education (P < .0001).

Conclusion: Patients and caregivers agree on the factors that are important in deciding treatment for advanced lung cancer but differ substantially from doctors. All agree that the oncologist’s recommendation is most important. This is the first study to demonstrate that, for some, faith is an important factor in medical decision making, more so than even the efficacy of treatment. If faith plays an important role in how some patients decide treatment, and physicians do not account for it, the decision-making process may be unsatisfactory to all involved. Future studies should clarify how faith influences individual decisions regarding treatment.

Supported by grant ACS IRG 97-151-01 from the American Cancer Society.

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