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Religious Terminally Ill Patients More Likely to Pursue Aggressive Treatment


As sickness progresses towards death, many patients find themselves turning to their religious faith for comfort and strength. But new research finds people who proclaim a strong reliance on religion are more likely to receive aggressive treatment as they die.

Researchers at the Beth Israel Deaconess Hospital in Boston asked patients with terminal illness and their family members about their religion and how they used it to cope.

Dr. Andrea Phelps says the study found most patients relied on religion in some form to help them deal with a terminal diagnosis.

"Nearly 80 percent of patients in our study reported that religion helps them to a moderate extent or more to cope with their illness," she says.

Phelps says people reported doing things like going to religious services, praying, meditating or studying the Bible to help them come to grips with their illness. But that religious devotion may have had a down side.

"We found that patients who used a high degree of positive religious coping were more than three times more likely to receive intensive life-prolonging care near death," Phelps says.

That care included interventions such as CPR - cardio pulmonary resuscitation, being on a breathing machine, or receiving extra chemotherapy in the week before death.

Phelps says she doesn't know why more highly religious people got more aggressive treatment. She suggests, however, that their faith gave them optimism about what the interventions might accomplish, or perhaps they felt more satisfied with their quality of life, even as it ends.

But one troubling aspect to this extra care is the effect it can have on grieving family members.

"We've previously showed that aggressive measures at the end of life are associated with a worse quality of death, and they are also associated with worse adjustment, worse mental health outcomes for their bereaved caregivers," Phelps says. "Very aggressive measures, at least for cancer patients, tend to be very burdensome treatment, and oftentimes do not provide much of a survival benefit. So even though you try to do these heroic measures to prolong life, a lot of the times they don't work."

Phelps says her findings might prompt doctors to be more frank with their terminally ill patients about treatment options and what patients stand to gain from them. Her paper is published in the Journal of the American Medical Association.

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