You’d think people with strong religious beliefs – which generally include belief in an afterlife – would be less perturbed about slipping of this mortal coil than the rest of us.
A new study published in the Journal of the American Medical Association, however, has found that cancer patients who rely on their religion for comfort during their final days are in fact almost three times more likely to use life-prolonging treatments than are less religious patients.
The authors of this study first used a questionnaire to assess ‘positive religious coping’ in 345 patients with advanced cancer. Religious coping – for example, prayer, meditation and religious study – can provide terminally ill patients with a sense of meaning, comfort and control during their last days. “Positive religious coping has been widely associated with improved psychological adjustment to stressors including serious illness”, the authors write.
The majority of patients (78.8%) reported that religion helped them cope ‘to a moderate extent’ or more, with a third saying that religion was the most important thing that kept them going. In addition, more than 50% of participants endorsed engaging in prayer, meditation, or religious study at least once a day.
Patients were then monitored until their death on average 122 days after this initial evaluation and their use of intensive life-prolonging care, such as mechanical ventilation or cardiopulmonary resuscitation, during their last week of life was recorded.
Patients who had a high level of positive religious coping were nearly three times more likely to use intensive life-prolonging end-of-life care treatments than were individuals with a low level of religious coping. This disparity persisted even once the authors had taken into account other factors that might affect end-of-life treatment decisions, such as terminal illness acknowledgment and preference for heroics.
Religious patients were also more likely to want physicians to do everything possible to keep them alive and less likely to make plans for the end of their life, such as instigating a do-not-resuscitate order or a living will.
“[I]ntrinsic to positive religious coping is the idea of collaborating with God to overcome illness and positive transformation through suffering. Sensing a religious purpose to suffering may enable patients to endure more invasive and painful therapy at the end of life”, say the authors. Highly religious patients “may choose aggressive therapies because they believe that God could use the therapy to provide divine healing, or they hope for a miraculous cure while intensive medical care prolongs life.
So the authors’ take seems to be that religious people use their faith to help them endure a painful treatment in the hope that the therapy, or God, might save their life, whereas less religious people lack such stoicism. Frankly, I’m quite surprised that religious people aren’t more ready to accept death when it comes, as they’re guaranteed a front-row seat in heaven. The rest of us, on the other hand, are likely to spend our last days consumed by existential angst and would surely want to prolong the final reckoning for as long as possible.
Phelps AC et al. (2009) Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients With Advanced Cancer JAMA 301 (11): 1140-1147 Abstract online