Religious Factors and Aggressive Medical Care at the End of Life: An Interdisciplinary Panel from the Coping with Cancer Study
Michael Balboni, PhD, ThM, Harvard Medical School
Tracy Balboni, MD, MPH, Harvard Medical School
Andrea Enzinger, MD, Harvard Medical School
Tyler VanderWeele, PhD, Harvard School of Public Health
The interdisciplinary panel will present recently published and unpublished data from the Coping with Cancer study—an ongoing NIH/NCI-funded, multi-institutional prospective research project that follows advanced cancer patients through the end of life and collects post-mortem information on patient medical utilization, costs, and quality of life.
Panelist, Andrea Enzinger, MD, will present data on the relationship of religious coping, religious beliefs, and aggressive medical care in the last week of life (“Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer.” JAMA. 2009 Mar 18;301(11):1140-7.). Her presentation reports that a high level of positive religious coping at baseline was significantly associated with receipt of mechanical ventilation compared with patients with a low level. In addition, her presentation reports that particular religious beliefs about end-of-life care are widely held and associated with greater preference for aggressive care. (12-15 minutes)
Panelist, Tracy Balboni, MD, MPH, will present data on the associations of medical utilization and spiritual care provided by the medical system (“Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death.” Journal Clinical Oncology 2010 Jan 20;28(3):445-52 ) and religious communities (“Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.” JAMA Internal Medicine 2013 Jun 24;173(12):1109-17). Patients whose spiritual needs were largely or completely supported by the medical team received more hospice care in comparison with those not supported. In contrast, patients reporting high spiritual support from religious communities were less likely to receive hospice, more likely to receive aggressive end-of-life measures, and more likely to die in an ICU. (12 minutes)
Panelist, Tyler VanderWeele, PhD, will present commentary on the Coping with Cancer Study’s epidemiological rigor, interpretation of the studies’ prevalence and relevance, and the social implications including costs (“Support of cancer patients' spiritual needs and associations with medical care costs at the end of life.” Cancer. 2011 Dec 1;117(23):5383-91). (10 minutes)
Panelist, Michael Balboni, PhD, will summarize a theological perspective on the findings and suggest a practical response by the medical system and religious communities. (10 minutes)
The final 15 minutes will provide the audience opportunity to respond and ask questions.
Tracy Balboni, MD, MPH, Harvard Medical School
Andrea Enzinger, MD, Harvard Medical School
Tyler VanderWeele, PhD, Harvard School of Public Health
The interdisciplinary panel will present recently published and unpublished data from the Coping with Cancer study—an ongoing NIH/NCI-funded, multi-institutional prospective research project that follows advanced cancer patients through the end of life and collects post-mortem information on patient medical utilization, costs, and quality of life.
Panelist, Andrea Enzinger, MD, will present data on the relationship of religious coping, religious beliefs, and aggressive medical care in the last week of life (“Religious coping and use of intensive life-prolonging care near death in patients with advanced cancer.” JAMA. 2009 Mar 18;301(11):1140-7.). Her presentation reports that a high level of positive religious coping at baseline was significantly associated with receipt of mechanical ventilation compared with patients with a low level. In addition, her presentation reports that particular religious beliefs about end-of-life care are widely held and associated with greater preference for aggressive care. (12-15 minutes)
Panelist, Tracy Balboni, MD, MPH, will present data on the associations of medical utilization and spiritual care provided by the medical system (“Provision of spiritual care to patients with advanced cancer: associations with medical care and quality of life near death.” Journal Clinical Oncology 2010 Jan 20;28(3):445-52 ) and religious communities (“Provision of spiritual support to patients with advanced cancer by religious communities and associations with medical care at the end of life.” JAMA Internal Medicine 2013 Jun 24;173(12):1109-17). Patients whose spiritual needs were largely or completely supported by the medical team received more hospice care in comparison with those not supported. In contrast, patients reporting high spiritual support from religious communities were less likely to receive hospice, more likely to receive aggressive end-of-life measures, and more likely to die in an ICU. (12 minutes)
Panelist, Tyler VanderWeele, PhD, will present commentary on the Coping with Cancer Study’s epidemiological rigor, interpretation of the studies’ prevalence and relevance, and the social implications including costs (“Support of cancer patients' spiritual needs and associations with medical care costs at the end of life.” Cancer. 2011 Dec 1;117(23):5383-91). (10 minutes)
Panelist, Michael Balboni, PhD, will summarize a theological perspective on the findings and suggest a practical response by the medical system and religious communities. (10 minutes)
The final 15 minutes will provide the audience opportunity to respond and ask questions.