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Minorities Likely to Keep Fighting Death to the End

Recent study revelations by a growing body of research and leading experts show that African Americans and other minorities are less likely// to agree to hospice and palliative care, while fighting terminal diseases.

Explaining why, is the difficult part. Some believe that it maybe due to language barriers, which make it hard for doctors to inform terminally ill members of minority groups of just how sick they actually, are. Yet others believe that "people with higher income and more access to treatment are about twice as likely to feel comfortable with withdrawing care as those of more modest means."

The largest study to examine the matter is an ongoing Harvard project funded by the National Cancer Institute.

The Harvard researchers who looked at 800 terminally ill cancer patients in five states, found that African-Americans were two to three times as likely as whites to want everything possible done to keep them alive.

The repercussions, the studies reveal are that they are more likely to die in the hospital, in pain, on ventilators and with feeding tubes, often being resuscitated or getting extra rounds of chemotherapy, dialysis or other care.

Says Richard Payne, who administers the Institute of Care at the End of Life at Duke University, “ I think we need to be very attentive to suffering in our patients and do everything we can to help minimize and ameliorate it."

While people of all races can find it hard to discuss death ahead of time and to accept that hope is gone, such fears may make some minorities even more likely to prolong treatment. African Americans and other minorities are far less likely to prepare living wills or sign do-not-resuscitate orders, according to many studies.

There has been less research on the attitudes of Hispanics and other minorities, but hospice workers and palliative-care specialists report similar trends, although each group has unique views.

Latinos and Asians tend to procrastinate telling terminally ill family members that they are dying, for fear that might hasten the end. Language barriers can further complicate care. Questionable immigration status may also make families hesitant about taking the legal steps necessary to enroll loved ones in hospice programs.

Leslie J. Blackhall who studies such issues at the University of Virginia echoes the study findings, “We don't want to stereotype people, but overall many, many studies have found that African Americans tend to want more aggressive care at the end of life."

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