Religion's Impact on End-of-Life Care
Patients Who Rely on Religion to Cope Are More Likely to Have Aggressive Medical Care
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Prigerson and colleagues reported that the association between religious reliance and use of aggressive medical intervention near the time of death persisted after other factors such as race, coping styles of patients, and advance medical care planning were considered.
But Duke University Medical Center psychiatrist Harold Koenig, MD, is not convinced that race did not influence the findings. He says that earlier studies have shown that blacks and Hispanics are more likely to have aggressive medical interventions at the end of life than whites.
In the newly reported study, blacks and Hispanics were much less likely to report a low level of reliance on religious coping than whites. Of the patients who said they did not rely on religion much, 6% were black, 9% were Hispanic, and 83% were white.
Patient-Doctor Discussions on Spiritual Issues
Koenig, who co-directs the Center for Spirituality, Theology and Health at Duke University, says the study underscores the importance of discussing religious beliefs within the medical setting.
"A recent study found that only about 7% of physicians actually talked to their dying patients about religious or spiritual issues," he tells WebMD. "There is also research finding that when doctors engage in discussions about spirituality with cancer patients, the patients trust them more."
There is also some evidence that incorporating spiritual counseling into end-stage medical care results in better quality of life and less aggressive medical intervention prior to death.
Prigerson, who directs the Dana-Farber Center for Research on Psycho-Oncology and Palliative Care, says aggressive end-of-life medical interventions have costs that go far beyond patient quality of life.
She points out that fully a third of the Medicare budget each year is spent treating patients in their last year of life, and a third of that expense occurs in the month before patients die.
"In the long run, many of these interventions result not only in more patient suffering, but they have huge costs for society," she says.