Comments on: Once Again, Race Matters-But How? http://www.compassionandchoices.org/2010/10/26/once-again-race-matters-but-how/ End-of-Life Choice, Palliative Care and Counseling Sun, 29 Jul 2012 05:06:15 +0000 hourly 1 http://wordpress.org/?v=3.4.1 By: M. Kirby, Librarian http://www.compassionandchoices.org/2010/10/26/once-again-race-matters-but-how/#comment-410 M. Kirby, Librarian Wed, 03 Nov 2010 17:19:02 +0000 http://blog.compassionandchoices.org/?p=1130#comment-410 Arch Intern Med. 2010 Sep 27;170(17):1533-40. Racial disparities in the outcomes of communication on medical care received near death. Mack JW, Paulk ME, Viswanath K, Prigerson HG. Department of Pediatric Oncology and Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. Jennifer_Mack@dfci.harvard.edu CONCLUSIONS: End-of-life discussions and communication goals seem to assist white patients in receiving less life-prolonging EOL care, but black patients do not experience the same benefits of EOL discussions. Instead, black patients tend to receive life-prolonging measures at the EOL even when they have DNR orders or state a preference for symptom-directed care. Arch Intern Med. 2010 Sep 27;170(17):1533-40.
Racial disparities in the outcomes of communication on medical care received near death.

Mack JW, Paulk ME, Viswanath K, Prigerson HG. Department of Pediatric Oncology and Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. Jennifer_Mack@dfci.harvard.edu

CONCLUSIONS: End-of-life discussions and communication goals seem to assist white patients in receiving less life-prolonging EOL care, but black patients do not experience the same benefits of EOL discussions. Instead, black patients tend to receive life-prolonging measures at the EOL even when they have DNR orders or state a preference for symptom-directed care.

]]> By: Sharon Minzer, M.D. http://www.compassionandchoices.org/2010/10/26/once-again-race-matters-but-how/#comment-409 Sharon Minzer, M.D. Mon, 01 Nov 2010 20:54:49 +0000 http://blog.compassionandchoices.org/?p=1130#comment-409 I am a physician of 27 years. Unless we, as physicians, are told "not to do something" the only other alternative is full speed ahead (with a positive or negative DNR) I fully support your stance and am a member. But from experience, I have had the most difficult times with African Americans as far as discussions about "less aggresive/comfort care." I certtainly haven't kept records, but I suspect that pehaps "more aggressive care" was given to blacks than white because the physicians may have been told do "do everything" (feeding tubes, IV antibiotics, hospitilization etc all short of DNR) We are also reluctant to do anything but aggressive care if there is a huge family disagreement (which sometimes happens) You don't know the number of times I have tried to seek less aggressive/comfort care to many of my stroke victims, some of wom are in a chronic vegetative state. Rarely, if at all, has a black family agreed. I would like a reference to the study you quote. Thanks and carry on the good work! Sharon Minzer, M.D. I am a physician of 27 years. Unless we, as physicians, are told “not to do something” the only other alternative is full speed ahead (with a positive or negative DNR)
I fully support your stance and am a member. But from experience, I have had the most difficult times with African Americans as far as discussions about “less aggresive/comfort care.” I certtainly haven’t kept records, but I suspect that pehaps “more aggressive care” was given to blacks than white because the physicians may have been told do “do everything” (feeding tubes, IV antibiotics, hospitilization etc all short of DNR) We are also reluctant to do anything but aggressive care if there is a huge family disagreement (which sometimes happens)

You don’t know the number of times I have tried to seek less aggressive/comfort care to many of my stroke victims, some of wom are in a chronic vegetative state. Rarely, if at all, has a black family agreed.
I would like a reference to the study you quote.

Thanks and carry on the good work! Sharon Minzer, M.D.

]]>