Religious coping linked to more aggressive terminal cancer treatment

Summarized by Susan Aldridge, PhD, medical journalist
March 27, 2009

Summary

People deal with terminal cancer in various ways, sometimes turning to religion for comfort and support. A new study shows that those who use religious coping are more likely to choose life-saving treatment in the last week before death. This choice can lead to a poorer quality of death and doctors need to be aware of the influence religion might have on the patient at the end of his or her life.

Introduction

Patients who know they are nearing the end of their lives find various ways of dealing with the situation. Some turn to religion, finding that prayer, meditation and reflection can give a sense of meaning and resolution. However, not much is known about how so-called religious coping affects the medical decisions the patient makes.

What was done

Researchers at Beth Israel Deaconess Medical Center in Boston, and colleagues, looked at the link between religious coping and receipt of intensive medical care in the final week of life. A group of 345 patients with advanced cancer was asked about religious coping, advance care planning and also end-of-life treatment preferences. They were also followed up until they died to record what treatment they actually received.

What was found

Nearly 80% of the patients said that religion helped them to cope with their illness. And one third said it was the most important thing to keep them going. Just over a half thought it was a good idea to engage in prayer, meditation or some form of religious study. The patients with a high level of religious coping were three times more likely than the person with a low level of religious coping to receive intensive measures like mechanical ventilation in the last week of life. They were also less likely to have left advance directives or do-not-resuscitate orders.

What this study means

Clinicians need to recognize and be sensitive to the role that religious coping plays in medical decisions at the end of life. They may wish to include other health professionals in discussing these matters. For aggressive care at the end of life to prolong that life at all costs leads to a poorer quality of death and emotional issues for friends and family.

Source

• Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer AC. Phelps, PK. Maciejewski,  et al, Journal of the American Medical Association, March 18 2009, vol. 301, pp. 1140--1147