Blacks more likely to want end-of-life intervention
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Blacks are more likely than whites to want life-sustaining care at the end of life for an incurable illness or a serious physical or mental disability, a new study shows.
While more than half of black individuals surveyed said they would want life support if they had a chronic condition and were brain dead, just 11 percent of whites would want this intervention. Nearly three quarters of blacks said they would want life-sustaining care if they were terminally ill and had senile dementia, compared with 22.2 percent of whites.
These preferences are in conflict with the “prevailing ethic” of the U.S. medical establishment that “it’s not advisable to offer life-extending treatment to people in a terminal situation,” Dr. William A. Bayer of the University of Rochester in New York, the study’s lead author, told Reuters Health.
Bayer was prompted to do the study after noticing how black families frequently wanted a loved one to stay on life support, while hospital staff—largely white - though it should be discontinued.
A number of other studies, he and his colleagues note, have found a preference among blacks for life-sustaining care such as CPR and mechanical ventilation at the end of life.
Bayer’s group asked 50 black and 27 white men and women who were 50 years of age or older if they would want life-sustaining care in eight different scenarios involving different levels of mental and physical status, from their current state of mental functioning to dementia to coma to brain death.
Across the board, blacks were more likely to want life-sustaining care than whites, Bayer and his colleagues found. The differences were starkest in the scenarios involving brain death and senile dementia.
Bayer points out that the current perception among U.S. medical professionals that life-sustaining care should not be given to terminally ill patients is cultural, not absolute, and does also not necessarily offer economic benefits.
“In my practice as a family practitioner I’ve seen that if people don’t feel that the most was done in their eyes for their loved one it can have ramifications for many generations,” he said.
Bayer also urged everyone to appoint a health care proxy and talk with him or her about their preferences for life-sustaining care. “This would avoid a lot of trauma to the family trying to decide what their loved ones wishes would or wouldn’t be.”
SOURCE: Ethnicity & Disease, Autumn 2006.
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