When you're near death, how hard do you want doctors to work on keeping you alive? Would you want cardiopulmonary resuscitation in what might be your final days of a cancer death sentence? Is a ventilator the right way to go?
Researchers recently posed these sorts of questions to 345 advanced cancer patients at seven hospital and cancer centers around the United States, and the results were starkly different for the very religious and the not so.
You might think religious people would be most comfortable with the idea of death or at least the most ready to pass on. That would not exactly be right. The patients identied as positive religious copers — those who relied on faith to handle death and other trying times — were almost three times as likely to seek and receive life-prolonging care such as ventilators.
These religious copers were also less likely to have completed advance medical directives, such as living wills or do-not-resuscitate orders that would limit the potential intervention near the end.
The findings were published last week in the Journal of the American Medical Association.
Rather than try to suggest what the results might mean about how different people view life vs. death (fodder for future study, the researchers said) the study leaders suggest what the findings might mean for health care professionals:
"Beyond the significance of religious faith in coping with the emotional challenge of incurable cancer, it is important to recognize how religious coping factors into extremely difficult decisions confronting patients as their cancer progresses and death appears imminent," said lead author Andrea Phelps of the Dana-Farber Cancer Institute and Beth Israel Deaconess Medical Center. "Beyond turning to doctors for advice, patients often look to God for guidance in these times of crisis."
"Our results highlight how patients' ways of coping, particularly their use of religious coping, factor prominently into the ultimate medical care patients receive," said study team member Holly Prigerson, of Dana-Farber and Brigham and Women's Hospital. "This suggests that clinicians should be attentive to terminally ill patients' religious views as they discuss prognosis and treatment options with them."
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