Strong religious faith can comfort people who are dying of cancer, allowing patients to find meaning in their suffering and easing their passage from life.
But faith can be a "double-edged sword," says nurse Carol Taylor, director of the Center for Clinical Bioethics at Georgetown University. Some terminally ill patients latch on to stories of biblical miracles, hoping to be cured, instead of using their little remaining time to make peace with God and loved ones.
Yet even Taylor, who has counseled many dying patients, says she was surprised by the findings of a study in today's Journal of the American Medical Association, which examined the choices of dying cancer patients who relied strongly on their religious faith to cope with their illness.
These patients were three times more likely than others to receive intensive, invasive medical procedures, even in their last week of life, the study shows.
Those who used "positive" religious coping -- such as "seeking God's love and care," as opposed to people tormented by the belief that God was punishing or abandoning them -- were more likely to want doctors to do everything possible to keep them alive. Those tormented by spiritual questions, on the other hand, were not more likely to seek aggressive care.
The religious people in the study may have believed that God could work through aggressive medical procedures, says study author Holly Prigerson, associate professor of psychiatry at Harvard Medical School.
"We suspect they are waiting for a miracle," Prigerson says. "They are more likely to think that life is sacred and that their job is to prove their faith ... by staying alive as long as possible."
Yet aggressive procedures may intensify their suffering, says Taylor, who was not involved in the new study. Patients who are hooked up to a ventilator can't talk, so they can't have meaningful conversations with those they're leaving behind.
"Needlessly prolonging dying isn't a positive thing," Taylor says. "I would think someone with a mature religious faith would be more at peace, more able to accept death."
Prigerson says her research suggests doctors should be sensitive to the ways religion shapes a patient's treatment choices and consider including hospital chaplains or psychiatrists in conversations with patients.
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