liveonearth (liveonearth) wrote,
liveonearth
liveonearth

Religious People Want and Get More Heroic End of Life Care

http://jama.ama-assn.org/cgi/content/short/301/11/1140
http://news.bbc.co.uk/2/hi/health/7949111.stm
http://chinese.eurekalert.org/en/pub_releases/2009-03/jaaj-uor031309.php

--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).
Tags: cancer, death, disease, healthcare, isms, medicine, meditation, religion, stress
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