Faith in the balance: Examining religious and spiritual influences on cancer treatment decisions.

e23268 Background: Religion and spirituality are fundamental aspects of many individuals’ lives, providing guidance, comfort, and strength during times of illness. Previous research has shown that religious beliefs can significantly impact cancer patients’ treatment decisions. The role of religion and spirituality in patient decision-making, especially in oncology settings, is complex and multifaceted, often creating ethical dilemmas that healthcare providers must navigate carefully. Significant gaps remain in understanding how these beliefs interact with medical recommendations, particularly in life-threatening situations. Less is known about how oncology providers manage these conflicts. This qualitative, cross-sectional observational study explores how religious and spiritual beliefs influence cancer patients’ treatment decisions and how oncology providers navigate this terrain. Methods: Cancer patients and oncologists were invited to participate in one-on-one semi-structured interviews. Patients were asked open-ended questions about their views on the role of religion and/or spirituality in their decision-making, their willingness to accept or decline specific treatments, and the role of divine intervention or miracles in their care. The Trust in Medical Research Scale (TMR) was also included. Oncologists were asked to share their experiences when religious and/or spiritual beliefs conflicted with medical recommendations and their strategies to ensure appropriate care. All interviews were audio-recorded with participant consent, transcribed, and deidentified for analysis. Results: Forty-eight patients and thirteen providers were interviewed. 77% of patients identified as religious or spiritual, with 67% claiming their beliefs influenced their medical decision making. Only one patient reported experiencing a conflict between their beliefs and medical recommendations. When asked to describe a time when a patient’s beliefs significantly impacted their treatment decisions, 38% of providers recalled patients refusing treatment/chemotherapy and 54% recalled Jehovah’s Witnesses declining blood transfusions. 70% of providers expressed feeling prepared when these circumstances arise. When asked how providers should respond when religious beliefs conflict with medical advice, 16% of patients favored nonjudgmental discussion, 27% suggested advising the patient that the best treatment was the science supported treatment, and 57% believed providers should simply respect the patient’s decision. Conclusions: Religious and spiritual beliefs can shape cancer patients' decision-making, and providers must be prepared to provide informed, autonomous patient care.