We investigate how 30 pediatricians and pediatric oncologists who practice and teach at elite medical centers determine whether religion and spirituality are relevant to what Andrew Abbot (1988) calls their professional "jurisdictions." Through in-depth interviews we focus on their everyday interactions with patients and families. We ask: (1) How do they gather information about religion and spirituality and determine when that information is relevant to their professional work? (2) Do they perceive religion and spirituality to be a barrier or a bridge to medical care as they do what Thomas Gieryn (1983) calls "boundary work"? We find that pediatric oncologists more than pediatricians see religion and spirituality as relevant to their professional work, though still largely outside their professional jurisdiction. It is most relevant when families are making medical decisions and in end of life situations. Physicians tend to view religion and spirituality functionally, describing impermeable boundaries in medical decision making situations and more permeable boundaries at the end of life. Physicians view religion and spirituality as a barrier when it impedes medical recommendations and as a bridge when it helps families answer questions medicine inherently cannot. Such findings have implications for a wide range of professionals as they negotiate their jurisdictions, particularly around religion and spirituality, in everyday practice.

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