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Dying Wishes Followed More Often for Whites

Better communication needed for black patients, researchers say

THURSDAY, Oct. 22, 2009 (HealthDay News) -- Dying white cancer patients are more likely than black patients to have their end-of-life wishes respected, a new U.S. study shows.

Some black patients who asked not to be resuscitated or put on a ventilator received the treatment anyway and died in an intensive care unit, said the researchers. White patients who voiced a wish for aggressive care were three times more likely to receive it than black patients who had expressed the same desire.

"We're not saying that black treatment preferences were ignored. Black patients did want, and did receive, more aggressive care than whites. The disparity was in the effect of treatment preferences on care received -- not that black preferences didn't matter," senior author Holly Prigerson, of the Dana-Farber Cancer Institute in Boston, said in a news release from the institute.

The study included 234 white and 68 black patients with advanced cancer. They were interviewed at the start of the study and monitored until their death, which occurred an average of 3.5 months later.

"None of the white patients who reported the completion of a do-not-resuscitate order, or a DNR order, at baseline subsequently received intensive care in the last week of life. This did not prove to be the case for black patients. DNR orders did not significantly protect black patients from intensive end-of-life care in this study," Prigerson said.

This disparity may be because of disruptions in continuity of care for black patients and cultural differences that hindered patient-doctor communication. The findings highlight the need for better communication between black cancer patients and their cancer care providers.

The study was published online Oct. 5 and will appear in a future print issue of the Journal of Clinical Oncology.

More information

The American Cancer Society has more about end-of-life decisions.

SOURCE: Dana-Farber Cancer Institute, news release, October 2009
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