Postgraduate students

Holly Miller Jones, BM, MM, DipGrad, MA

Life-Prolonging Medical Care and Religiosity at the End of Life

Why are religious people more likely to request extraordinary end-of-life medical intervention?

Studies from around the world indicate that highly religious people request and receive more aggressive end-of-life medical care than their less religious counterparts. Research suggests that patients who express strong religiosity are less likely to engage in advanced care planning and more likely to desire and receive life-prolonging medical care such as resuscitation and mechanical ventilation.

Why would religious people be more likely to request and receive extraordinary end-of-life medical intervention than those who are less religious? The underlying mechanisms are currently unknown and seem to contradict a commonly held assumption that increased religiosity would ease dying.

The purpose of this study is to explore and understand the connection between an individual’s religiosity and his or her end-of-life medical decisions. End-of-life decisions are, at once, intensely personal and also a matter of public interest. Individuals want the option and wisdom to die well. Policy-makers and administrators have noticed the exponential increase in spending associated with end-of-life care. Physicians report concern that extraordinary end-of-life intervention may be harming more patients more than it helps. The current research can inform both religious and medical communities about who receives extraordinary end-of-life medical care and why.

This study used a qualitative approach that combined a literature review with in-depth interviews (n=14). The interview questions evaluated six hypotheses that have been proposed to explain the connection between religiosity and an increased likelihood of aggressive end-of-life medical care: suffering, sanctity of life, God’s sovereignty, miracles, afterlife, and social support. Interviews suggest that religious and nonreligious people hold different beliefs and opinions on theological topics, but these beliefs and opinions have little direct effect on a preference for life-prolonging medical care. In other words, the observed connection between religious patients and intensive end-of-life medical care may have less to do with the theological beliefs of the patient and more to do with the social support that religious people experience. Findings suggest that theological-based mechanisms may be more active in end-of-life situations involving younger patients who are perceived to have been thwarted in completing a natural course of aging.

Supervisors: Dr John Shaver and Dr Richard Egan