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Ethn Dis. 2006 Autumn;16(4):914-9.

Attitudes toward life-sustaining interventions among ambulatory black and white patients.

Author information

1
Department of Family Medicine, University of Rochester, Rochester, New York, USA. wbayer1@rochester.rr.com

Abstract

OBJECTIVES:

The purpose of this study was to evaluate racial differences in preference for life-sustaining interventions in the context of various physical and mental health scenarios.

DESIGN:

Data were collected by using an investigator-administered survey.

SETTING AND PATIENTS:

Consecutive patients who self-identified as African American or Caucasian were recruited from two private primary care practices in Rochester, New York.

MAIN OUTCOME MEASURES:

Patients were asked to decide whether they would accept or decline life-sustaining intervention in eight scenarios, each involving a different combination of mental and physical disability. Information on religiousness, family integration, and experience with creating a healthcare proxy was also collected, as these variables were believed to be potential confounders of the relationship between race and preference.

RESULTS:

Data from 77 patients (50 Black patients and 27 White patients) were analyzed. In multivariate log linear modeling, race was a significant predictor of preference for life-sustaining therapy, even after controlling for degree of mental and physical disability. Religiousness, family integration, and experience with creating a healthcare proxy did not explain racial differences in preference for life-sustaining therapy.

CONCLUSIONS:

We have shown that ambulatory Black patients aged > or = 50 years are more likely than White patients to prefer life-sustaining care, and that these preferences persist across a wide range of mental and physical disabilities. This attitude conflicts with the prevailing ethic regarding end-of-life care, and Black patients and their families may consequently find have difficulty obtaining medical care that is consistent with their cultural values and beliefs. Policy decisions regarding end-of-life care must reflect a culturally diverse perspective.

PMID:
17061746
[Indexed for MEDLINE]

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