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--Pious 'fight death the hardest', want the doctors to do everything in their power
--It is unclear why those who pray prefer more aggressive end-of-life care, "heroic measures"
--US study, Dana-Faber Cancer Institute
--n = 345 patients with terminal cancer, followed to death
--those who regularly prayed were 3x more likely to receive intensive life-prolonging care
--published in 3/18/09 Journal of American Medical Association (JAMA. 2009;301[11]:1140-1147)
--intensive life-prolonging care is often unconfortable/painful/awful, reduces quality of life
--U Pittsburgh School of Medicine researchers have found that ventilator support, resuscitation, feeding tubes and non-palliative chem assoc w/ psych and physical distress
--109 pts (31.6%) agreed that religion was "the most important thing that keeps you going"
--272 pts (78.8%) reported religion helps them cope “to a moderate extent” or more
--religious people least likely to have a DNR, more likely to be resuscitated
--pts w/ high level of positive religious coping at the start of the study had nearly 3x the odds of receiving mechanical ventilation, intensive life-prolonging care in last week of life
--this seems to be the 1st study showing that the religious actually get more end-of-life care (we already knew that they support/prefer it)
--end of life care reduces pts chance of dying in preferred location
--religion widely associated with improved ability to cope with stress/illness
--quote: "because aggressive end-of-life cancer care has been associated with a poor quality of death and caregiver bereavement adjustment, intensive end-of-life care might represent a negative outcome for religious copers"
--religious coper = regularly used prayer or meditation for support
--MEDITATION???? did they separate out any non-religious meditators in their study?
--lead researcher Holly Prigerson
--I found the first link to this info on the anti-theist community page, with a rumination that perhaps religious people were less reconciled to the uncertainty and finality of death than those who have not leaned on the crutch of religion all their lives
--Results: A high level of positive religious coping at baseline was significantly associated with receipt of mechanical ventilation compared with patients with a low level (11.3% vs 3.6%; adjusted odds ratio [AOR], 2.81 [95% confidence interval {CI}, 1.03-7.69]; P = .04) and intensive life-prolonging care during the last week of life (13.6% vs 4.2%; AOR, 2.90 [95% CI, 1.14-7.35]; P = .03) after adjusting for age and race. In the model that further adjusted for other coping styles, terminal illness acknowledgment, support of spiritual needs, preference for heroics, and advance care planning (do-not-resuscitate order, living will, and health care proxy/durable power of attorney), positive religious coping remained a significant predictor of receiving intensive life-prolonging care near death (AOR, 2.90 [95% CI, 1.07-7.89]; P = .04).


( 7 comments — Leave a comment )
Mar. 18th, 2009 11:22 pm (UTC)
Fascinating. One of the biggest questions in my mind when my grandmother was suffering from cancer treatment was "What happened to her faith?" - she was one of those people who had little prayer and inspirational books all over the house, pictures of Jesus, went to church regularly and talked of her faith often.

It was hard to watch her suffer so badly. I thought her faith in God would help carry her to a peaceful death but it wasn't so.
Mar. 19th, 2009 12:16 am (UTC)
I'm sorry your grandma didn't have a more peaceful end. I suppose watching her suffer didn't give you a lot of confidence in the religion she espoused.

The anti-theist idea that perhaps religion is used as a way of avoiding reality more often than it is a way of facing it may be true. There is certainly a large group of religious folks who I would categorize as religion addicts--as in, they engage in certain behaviors/beliefs compulsively to feel better when the actual causes of their discomfort are not acknowledged or dealt with. There must also be the other group--those whose religion HELPS them to accept and deal with reality. This study doesn't suggest a prevalence of that mindset. One of the toughest realities is that of inevitable death. We all want to dodge it.
Mar. 19th, 2009 01:38 am (UTC)
As a former hospice "chaplain" I found this fascinating, too.

This matches my experience. The more religious a person was - the more likely they were to seek aggressive care.

I wonder if it might be the case that people who are anxious by nature tend to be more "religious" and people who are anxious by nature also tend to want to use more aggressive health care.

I do know quite a few people who are quite "spiriitual" who have a "try everything" attitude about life and their spirituality is part of that "try everything" attitude.

I don't know if I'm being clear.
Mar. 19th, 2009 04:18 am (UTC)
I think I get it. You're saying that people who are anxious are more likely to seek religious comfort, and that anxiety may also correlate with wanting medical miracles when at death's door. ?? Seems like a possible extension of their findings, especially considering that your personal experience corroborates their findings.
Mar. 19th, 2009 12:55 pm (UTC)
Okay. You understand me, exactly. I was not sure that I was being clear.
Mar. 19th, 2009 01:50 am (UTC)
i saw in google news yesterday as well, interestingly enough i immediatly thought of you! i have noticed this tendency while working in the critical care unit-- though my observations are purely anecdotal. the very sickest folks who've got the big faith - they and their families are the most resistant to letting go. at some point with a brain dead patient i was foolish enough to attempt to point out how..... well, brain dead he was and how though the family kept praying for god's intervention death is a sort of miracle..... anyway the next evening i was called off work because the patient's wife threatened to kill me..... he "went home" shortly thereafter. it's a hard thing these folks seem to truely suffer, vents and drips and "invasive" life prolonging measures are far from gentle.
Mar. 19th, 2009 04:22 am (UTC)
Interesting that the life of the braindead was sacred to them, but that the wife was ready to "kill" you over words. The disconnect is bizarre to me.
( 7 comments — Leave a comment )



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