African-Americans get less EOL discussion
Physicians less likely to discuss issues
A new study on ICU physicians conducted by an assistant professor at Case Western Reserve University in Cleveland found that physicians are less comfortable discussing end-of-life issues and do it less frequently with African-American patients and their families than with Caucasian patients and families.
J. Daryl Thornton, MD, also of the Center for Reducing Health Disparities at MetroHealth Medical Center in Cleveland, led the study and presented his findings at the American Thoracic Society's International Conference in Toronto in May.
One in five Americans will die in the ICU or shortly following a stay in the ICU. Often, these deaths follow a decision by the patient's family to withdraw life-sustaining treatment, according to the university.
"That is why it is so important that physicians are comfortable delivering difficult and sometimes complex diagnoses, potential outcomes and prognoses to patients and families in the ICU," said Thornton. "Our study suggests there may be some underlying biases and/or discomfort among physicians, which impacts their ability to have these difficult conversations with families."
The researchers examined data from the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT), which was conducted between 1989 and 1994 involving a group of 9,105 seriously ill hospitalized patients and their 1,241 physicians at five major medical centers across the country.
After adjusting for a variety of factors such as severity of illness and insurance status, physicians reported having had prognostic conversations with 58% of their white patients but only 41% of their African-American patients.
The researchers acknowledged that the study data are "dated," but suggested that the findings should be replicated as an "important area for health disparities research."
A new study on ICU physicians conducted by an assistant professor at Case Western Reserve University in Cleveland found that physicians are less comfortable discussing end-of-life issues and do it less frequently with African-American patients and their families than with Caucasian patients and families.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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