Spirituality Presents a Paradox in End-of-Life Care

Cheryl Clark, for HealthLeaders Media , May 9, 2013

The amount of spiritual support received by terminally ill patients has a direct impact on the aggressiveness of their end-of-life care. But not in the way you're probably thinking.

Might God, or rather those who purport to represent the Lord's guidance, be blocking efforts to bend the nation's healthcare cost curve by pushing futile costly care on the terminally ill?

A study this week from the Dana Farber Cancer Institute prompts this provocative, admittedly incendiary question.

These may sound like fighting words to those of many faiths. Yet it's what I found myself asking after reading a paper by Dana Farber's, Tracy Balboni, MD, published this week in JAMA Internal Medicine.

Balboni, a palliative care specialist and core researcher for the institute's Center for Psychooncology and Palliative Care Research, surveyed several hundred patients with advanced cancer who received care at seven oncology centers in Boston, Dallas, and New Haven.

Her team asked these terminal patients to rank how much spiritual support they received from their pastors, priests, rabbis, or other members of their religious communities, compared with how much support they got from their medical team or hospital chaplain.

After the patients died, the researchers returned to their medical records to examine the aggressiveness of their end-of-life care.

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4 comments on "Spirituality Presents a Paradox in End-of-Life Care"

David Dismas (5/14/2013 at 2:16 PM)
Sadly I think that clergy are no more comfortable with death than the rest of the population ... what may appear to be pushing for the miracle may actually be avoiding the obvious at all costs. Fortunately, the hospital and hospice chaplains have [hopefully] worked through their issues with death and are in a better place to help the dying. Alas, I wish there was more outreach by those chaplains to help parish clergy process their issues around death and dying with an end towards better pastoral care.

Rev. Porch (5/10/2013 at 11:36 PM)
It has been my experience as a pastor, that families seeking aggressive care are the same ones who aggressively seek the pastor to be there. Are the researchers making a false assumption about cause and effect? Is there an underlying cause that effects the level of spiritual support and the level of medical care? Does aggressive medical care cause the pastor to show up more often? In my experience the answer is yes. I believe the level of pastor care and medical care are related, but both are the results, not the cause.

Peggy Salvatore (5/9/2013 at 5:11 PM)
This exactly corresponds to an experience I am having right now with my dying uncle. We have a faith-based family, and they are taking extraordinary measures. I found this perplexing, but this explains it.




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