decision making, end-of-life treatment, ethics, religion, spirituality, trustworthiness, vulnerability



  1. Lazenby, Mark PhD, APRN, FAPOS


This article explores the ethical issues that arise when patients' and families' religious beliefs collide with clinicians' views of appropriate end-of-life decisions. The article begins with a case study drawn from clinical experience that focuses on the need for a surrogate decision maker for a deeply religious patient in the intensive care unit with life-limiting cancer. The patient's adult children, also religious, against the health care team's clinical advice, want all life-extending measures taken as they await a divine miracle. The conflict between the family and the health care team points to (1) the ethical issues of patients' and families' status of vulnerability and the health care team's necessary moral response to this status; (2) the moral obligation of the health care team to show their trustworthiness to the family by showing the family the team's competence, honesty, and reliability; and (3) the moral obligations of the health care team to provide the patient and family spiritual support.