Patient requests for “inappropriate” medical treatment (violations of the standard of care) based on religious beliefs should have special standing. Nevertheless, not all such requests should be honored, because some are morally disturbing. The trouble lies in deciding which ones count. This paper proposes criteria that would qualify a religious belief as medically valid to help physicians decide which requests to respect. The four conditions suggested are that the belief (1) is shared by a community, (2) is deeply held, (3) would pass the test of a religious interpreter and (4) does not harm others.
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Competing interests: None declared.
↵i Savulescu also makes the stronger claim that religious beliefs are less rational than others (implication: they have less standing) Religious requests, he claims, are based on irrational beliefs that are probably false. Ethics, on the other hand, is reasonable and factual. Such a bold claim is problematic, but I do not have the space here to make a robust case for the rationality of religious belief. Much has been written on this subject. One good example is Bruntrup and Tacelli.4 Apart from whether religion is rational or not, I think Wreen2 makes a solid argument that religions are special and worthy of consideration; see also Smith.5
↵ii “Clearly defined” in the sense that their identity is not wrapped up in their community’s rituals and practices (see Savulescu,3 p382).
↵iii Some groups discourage skepticism or questions among their adherents. I am open to the idea that such groups should be given less consideration. Open-mindedness is an intellectual virtue; nevertheless, I don’t think that this is a problem for my argument. Adherents of a dogmatic sect, at a bare minimum, share in the epistemic resources of the community (impoverished though it may be). This is more than can be said of the religious maverick, whose ideas have not been tested by the community or have not withstood the test of time and tradition.
↵iv This does not represent a licence to disrespect cultural beliefs, but only to draw a line between deeply held religious beliefs and other, lesser-held beliefs that constitute an individual’s identity.
↵v Thanks to John Hardwig for this insight.
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