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Dying, Desperately, Heroic

“To study philosophy,” wrote the French essayist Montaigne, “is to learn how to die.” In medieval times, particularly as the Black Death spread through Europe, the art of dying—ars moriendi—became the goal to which a lifetime of piety was devoted. Sure, a person can get by faking a good life. But a good death? There’s the true test.

This week there has been a bunch of buzz about a new study published in the Journal of the American Medical Association which noticed that the more religious people are, the more they reach for extreme medical treatments in their last days, refusing to give up the ghost. They are also less likely to have prepared ahead of time for dying by drawing up wills and arranging for healthcare proxies.

Any study about religion and health is sure to push some buttons. There’s a whole collection of foundations out there (Templeton, Pew, Lilly, etc.) looking to give out money to scientists who are, as Richard Dawkins put it, “willing to say something nice about religion.” This particular study received money from one of those, the Fetzer Institute.

In the media coverage, however, there’s been an interpretive tug-of-war-going on. The original paper, whose lead author is Andrea Phelps of Beth Israel Deaconess Medical Center in Boston, makes mention of the “heroic measures” that these dying religious folks call for—it’s a bit of medical jargon, meant not necessarily to bespeak actual heroism. Run a Google search on “heroic measures religious” today, and the first thing you get is a cheery article in the Desert News, the Salt Lake City paper.

It isn’t clear why these patients pursue more aggressive treatment, said Andrea Phelps, a senior medical resident at Beth Israel Deaconess Medical Center in Boston and the study’s lead author. It may be that people with a strong sense of faith are more optimistic or are more satisfied with their quality of life, Phelps said. Doctors should be sensitive to religious beliefs and help plan care accordingly, Phelps said.

Look through three other reports from less theocratic points of origin—the Economist, the Boston Globe, and Scientific American—and, quite to the contrary, they paint the religious folks as somewhat more like crazed and desperate souls whose supernatural worldviews crumble at the threat of natural demise. The Darwin-loving Economist compares the poor believers’ behavior to the pre-conversion hypocrisy of Augustine:

Saint Augustine of Hippo, one of Christianity’s most revered figures, famously asked God to help him achieve “chastity and continence, but not yet”. When it comes to meeting their maker, many religious people seem to have a similar attitude.

Points out SciAm, the poor suckers (who all died) hold out hope against hope:

“Religious copers may choose aggressive therapies because they believe that God could use the therapy to provide divine healing, or they hope for a miraculous cure while intensive medical care prolongs life,” the scientists speculate in the study.

But let’s take the final word from none other than Watergate-conspirator-cum-theological-statistician Chuck Colson. He has a point worth noting:

The “vast majority” of the patients–some 90 percent of those who were religious and 97 percent of those who were not–did not want “heroic measures,” such as mechanical ventilators or CPR, to be used in their cases.

Based on that seven percentage-point difference the New York Times proclaimed “Religious Belief Linked to Desire for Aggressive Treatment in Terminal Patients.” Please.

Do a little more math and you will realize that sweeping generalizations like “far more likely to seek aggressive, life-prolonging care” are based on the responses of approximately 25 people.

And what, exactly, are we supposed to make of his conclusion?

Religion can be a problem if it makes people want to stay alive longer. As we nationalize healthcare, as Smith warns, the sick and infirm will soon be told they should do the patriotic thing: go quietly.

Are we about to lose our God-given freedom to cling on to dear life futilely, painfully, and at the expense of our brethren?

4 comments on “Dying, Desperately, Heroic

  1. Very good. There is something horrible about the way the medical industry sells tiny life extensions.

  2. If hell weren’t such a scary place, maybe religious folks would be more inclined to go quietly into that good night.

  3. I feel like it’s too easy to pass judgment on theoretical individuals who are made out of statistics. I doubt any of us would say to a dying person who has already suffered through the ordeal of cancer and cancer treatment, “Oh come on, why waste our resources just so you can have a few more days of life?” The people who did choose to go on the ventilators or be resuscitated only had a week left on earth anyway. I don’t see how it even matters whether they were religious or not as far as the medical establishment is concerned. I wonder if the reseachers thought to ask if the dying persons had had a chance to say goodbye to their loved ones yet. I imagine that some of the “yes to ventilator” people were probably waiting or hoping for loved ones to come say goodbye, rather than for a miracle cure to happen.

  4. Yes, it is always important to remember the limitations of what a scientific study can tell you. For good reasons, researchers have to really limit themselves in the kinds of variables they are analyzing in order to make sure to really locate the right chains of causation. In the process, a lot of important details can be lost.

    That said, there is much that can be noticed through careful, rigorous, and superficial statistical studies that the anecdotes of ordinary human experience won’t reveal.

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