Cosmos-Liturgy-Sex

A good friend of mine who is a PA has been keeping tabs on the attack on conscience of both health care providers and patients in the health care industry. He recently pointed to two medical news outlets (Today In Medicine & Medical Watch) which carried a New York Times article about studies looking at the relationship between end of life decisions and religious belief.

The NYT entitled the article: “Religious Belief Linked to Desire for Aggressive Treatment in Terminal Patients,” while the medical news aggregators used the title, probably having picked it up from another source: “Devout terminally ill patients may be more likely to seek aggressive, life-prolonging treatment, study suggests. ” The NYT is well known for its promotion of culture of death ideology and this article is no exception. However, it is a report about a study which is to be published in JAMA.

The med news aggregators assembled the story from a variety of sources, who had expounded upon the NYT piece and here is what they came up with:

Devout terminally ill patients may be more likely to seek aggressive, life-prolonging treatment, study suggests.

The New York Times (3/18, A18, Rabin) reports, “Terminally ill cancer patients who drew comfort from religion were far more likely to seek aggressive, life-prolonging care in the week before they died than were less religious patients.” According to research team member Holly G. Prigerson, MS, PhD, of Harvard University and the Dana-Farber Cancer Institute, the finding seems to contradict what some people tend to generally accept as true: “Spiritual patients are more likely to say their lives are in God’s hands.” But, “to religious people, life is sacred and sanctified,” Prigerson maintains.

In fact, she says, “there’s a sense that by not going for life-prolonging care, they’re letting God down,” the Los Angeles Times (3/18, Kaplan) adds. A number of “other recent studies have made similar connections.” For example, “religious cancer patients who had unsuccessful chemotherapy treatments were twice as likely to want heroic end-of-life measures, according to a report last year in the Journal of Clinical Oncology.” And, a “2005 study in Annals of Behavioral Medicine found that patients with advanced-stage lung or colon cancer were more likely to want life-preserving CPR, mechanical ventilation, and hospitalization if they believed in divine intervention.” The current study, published in the Journal of the American Medical Association, adds to the assertion that “faith in a higher power can often lead to more aggressive treatment than is medically warranted.”

In fact, the study reveals that the highly devout patients they interviewed “were three times more likely than others to receive intensive, invasive medical procedures,” USA Today (3/18, Szabo) reports. They “also made fewer preparations for death, such as filling out ‘do not resuscitate’ orders, writing living wills, or giving someone power of attorney, according to the study of 345 patients” recruited from medical facilities throughout the country between 2003 and 2007. The participants were predominantly Christian.

Although some “79 percent of patients reported that religion helped them cope to some extent,” just one-third “of highly religious patients had a do-not-resuscitate order, compared with half of patients who weren’t as spiritual,” Bloomberg News (3/18, Lopatto) points out. Instead, “they wanted physicians to take ‘heroic measures’ to keep them alive.”
Meanwhile, “the researchers also observed that positive religious coping was significantly associated with being black or Hispanic, and that those with a high level of positive religious coping tended to be younger, less educated, less likely to be insured, less likely to be married, and more likely to have been recruited from sites in Texas than those with low levels of religious coping,” according to Medscape (3/17, Nelson).

The “mechanism underlying the association between religious coping and aggressive life-saving measures is unclear,” MedPage Today (3/17, Neale) reported. The investigators hypothesized, however, that “highly religious patients ‘may choose aggressive therapies, because they believe that God could use the therapy to provide divine healing, or they hope for a miraculous cure while intensive medical care prolongs life.’”

Duke University Medical Center psychiatrist Harold Koenig, MD, told WebMD (3/17, Boyles) that “the study underscores the importance of discussing religious beliefs within the medical setting.” Even though another “recent study” showed “that only about seven percent of physicians actually talked to their dying patients about religious or spiritual issues,” Dr. Koenig says that “there is also research finding that when doctors engage in discussions about spirituality with cancer patients, the patients trust them more.” In addition, “incorporating spiritual counseling into end-stage medical care results in better quality of life and less aggressive medical intervention prior to death.” Prigerson agreed, noting that “aggressive end-of-life medical interventions have costs that go far beyond patient quality of life.” Not only do aggressive treatments “have huge costs for society,” she contended that “many of these interventions” also “result…in more patient suffering.”

The Boston Globe (3/18, Cooney), Ohio’s Columbus Dispatch (3/17, Crane), BBC News (3/17), AFP (3/18), CBC News (3/17), and HealthDay (3/17, Gordon) also covered the story.

The focus of the article appears to make the point that doctors need to be vigilant about people exhibiting a strong faith because they are draining society of resources that might go to more productive people. A couple of things to note here. The author is concerned first, with the economic impacts to society of what she considers to be unwarranted, aggressive treatment. Second, she is concerned with “more patient suffering.”

This, I suspect, is utilitarianism at its finest. As the summaries do not indicate the nature of what is considered “aggressive treatment” it is hard to know what the author means. However, feeding tubes and breathing assistance are now considered extraordinary care in some cases. Even actively taking a life is being euphemistically referred to as “being allowed to die.”

The economic value of the life versus the cost to society has become a primary concern for too many responsible for giving “care”. This eugenic mindset is a frightening trend that seems to be gaining traction in the medical community. Of course, it is being couched also in the pseudo-compassionate concern for ending suffering as a further justification for eugenic murder. In fact, the “choice” to end suffering is the main plank in the strategy. However, lurking not far off in the shadows are the bean-counters who seem itching to put on price on everyone’s head.

A second consideration is the reason for highlighting being religiously devout. It is not clear what this even means. It clearly does not provide anything insightful, as if being religiously devout refers to a monolithic set of beliefs. The summaries show that there are also other factors that are correlated as well such as age, economic status, level of education, marital status. Why do not one of these not merit top billing?

I suspect that what we have here is a utilitarian, eugenic mindset that naturally is going to see people of faith as those opposed to their attempts to establish as a “good death” framework for parceling out care and ending “senseless” suffering. This thinking is not new. However, what only a few years ago was on the fringe has become mainstream in Europe and with the ascendancy of a europhile Congress and presidential administration the push to go mainstream in the US is sure to heat up. This will be especially true as the new administration moves to establish a state run heathcare that will not bust the budget.

The eugenicists are right in recognizing that their foes will be people of faith, which is why it will become more are more challenging to be an faithful Catholic in the years to come.