Religion and Intensive Life Prolonging Care when Near Death

A study recently published by JAMA (Religious Coping and Use of Intensive Life-Prolonging Care Near Death in Patients with Advanced Cancer. The Journal of the American Medical
Association 2009, 301(11): 1140-1147) looked at how religious faith impacted whether near death cancer patients wanted life-prolonging care even when such care did not offer any cure. A total of 345 patients with advanced cancer were followed until death and were interviewed to determine their religious coping mechanisms. Life prolonging procedures were defined as receiving mechanical ventilation or resuscitation in the last week of life.

You would think that a person who believed in a wonderful afterlife where there is no sorrow or tears (Rev 21:4) and a place where they will live in everlasting bliss would look forward to such an encounter. On the other hand, you would think that an atheist who has no belief in an afterlife would hang on to life until the bitter end. If you think this, you would be wrong. This study showed that those people with high religious coping mechanismsare approximately 3x as likely to request life prolonging care even when it isclear that such care will not result in a cure but rather only prolong life for a brief period of time. While the overall numbers of patients seeking these life-prolonging measures are not great (10 – 18%), the differences between the 2 groups are significant. The obvious question one has to ask is why the difference, especially when it is opposite of what you would normally think.

One group made the following comment: “These are important observations and point out the need for physicians to understand patients’ spiritual needs. The reasons that religious
patients want to prolong life as long as possible even if the quality of life is poor are poorly understood. Possibly, there is a greater belief in divine intervention than is generally thought. Clearly, the belief in a heavenly afterlife carries very little weight in a patient’s decision making about prolonging life on earth.” (CancerConsultants.Com) But it should, shouldn’t it?

Why do those with religious coping mechanisms have a higher desire to prolong-life?

1. Maybe they feel they would be letting god down if they gave up?

2. Maybe they believe that by “buying” time, it gives god more time to miraculously heal them?

3. Maybe they need more time for prayers to be answered?

4. Maybe they really don’t believe in the wonderful afterlife they have been promised?

5. Maybe they believe that their sins can’t be forgiven and they are going to hell?

6. Maybe they aren’t real believers (a common Christian out)?

7. Maybe they are more tied to this world than the one to come (a no, no for Christians)?

8. Maybe they aren’t so sure about their “salvation”?

9. Maybe those who use “religious” coping mechanisms aren’t as religious as they would like others to believe?

9. Maybe atheists are just realists are believers are just used to having their heads in the clouds?

In any case, it would appear that for some religious people there is a huge disconnect between what they say they believe and how they act, especially when death is imminent.