Highly Religious Patients Fight to Live Longer

( [email protected] ) Mar 18, 2009 09:42 AM EDT

A new study on patients with advanced cancer found that those who used their religious faith to cope with their illness were far more likely to want doctors to do everything possible to keep them alive than were less religious patients.

Patients with a high level of "positive" religious coping – seeking God's love and care – were three times more likely than others to receive intensive life-prolonging treatment in their last week of life, according to a study published Wednesday in the Journal of the American Medical Association.

"People think that spiritual patients are more likely to say their lives are in God’s hands – 'Let what happens happen' – but in fact we know they want more aggressive care," said Holly G. Prigerson, the study’s senior author and director of the Center for Psychosocial Oncology and Palliative Care Research at the Dana-Farber Cancer Institute in Boston, according to The New York Times.

"To religious people, life is sacred and sanctified, and there's a sense they feel it's their duty and obligation to stay alive as long as possible," she added to the NY Times.

According to the new study, which examined 345 patients until they died, nearly 80 percent reported that religion helps them cope "to a moderate extent" or more and more than a third said religion "is the most important thing that keeps you going." Also, 55 percent endorsed engaging in times of prayer, meditation, or religious study at least daily.

Compared to less religious patients, those with a high level of positive religious coping were less likely to sign a do-not-resuscitate order, prepare a living will, or name a health care proxy.

Moreover, about 10 percent of those who had high levels of religious coping were in the intensive care unit in their last week of life, compared with 4.2 percent of patients who had low levels of religious coping.

The study's findings surprised some.

The Rev. Angelika Zollfrank, a chaplain and the director of clinical pastoral education at Mass. General, told The Boston Globe, "We certainly see religious patients and families go both ways in terms of religious coping. There are very religious people who want aggressive treatment, and there are also religious people who know that there is a time for everything, a time to be born and a time to die."

While religion may influence patients' medical decisions, Dr. Harold Koenig, director and founder of the Center for the Study of Religion/Spirituality and Health at Duke University, noted that many patients as well as doctors are uncomfortable with bringing the subject up.

But he encouraged patients to bring up religion with their doctors if it's important to them.

"There's no other way than for patients to be bold," Koenig, who was not involved in the study, told ABC News.

The study’s' authors also encourage the same.

"These results highlight the need for clinicians to recognize and be sensitive to the influence of religious coping on medical decisions and goals of care at the end of life," the authors wrote. "When appropriate, clinicians might include chaplains or other trained professionals (e.g., liaison psychiatrists) to inquire about religious coping during family meetings while the patient is in an intensive care unit and end-of-life discussions occurring earlier in the disease course."

Prigerson noted, "A greater understanding of the basis of patients' medical choices can go a long way toward achieving shared goals of care."

Previous research has shown that more religious patients often prefer aggressive end-of-life treatment. But the new study is the first to examine patients in their final days.