Spirituality Presents a Paradox in End-of-Life Care
"What we found is that patients who said they received a high amount of support from those religious communities were less likely to receive hospice care, more likely to receive aggressive medical interventions such as care in the intensive care unit, resuscitation, mechanical ventilation, and were more likely to die in an ICU setting, compared with patients who were not highly supported by their religious communities," Balboni says.
Those more heavily influenced by religious groups were less likely to have a high quality of life in their final days, she says.
A Belief in Miracles
The more they received support from religious congregations, the more likely patients were to fight death through experimental, highly toxic regimens of chemotherapy or surgeries with little chance of success. Apparently, these patients believed that God, acting through doctors, hospitals, and drugs, would miraculously save them, Balboni surmises.
"What the data suggests is that there is a lack of understanding on the part of these religious communities about the medical realities that these patients are facing, [and] that they focus instead on praying for miracles and perseverance through aggressive therapies."
On the other hand, when patients received their spiritual support from hospital chaplains, they received forthright and realistic information bridging the facts of their medical situation with their end-of-life considerations and religious beliefs.
"The chaplain elicits the patients' values and goals, and how they want to spend their remaining time, and gets them to consider weighing the potential benefits and risks of particular therapy," Balboni explains. "The chaplains have one foot in each realm."
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