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End-of-Life-Care Different Between Black and White Patients
"Although black patients are also more likely than white patients to desire life-prolonging measures, receipt of life-prolonging care at the end of life is associated with greater distress and with poorer quality of life," the authors write as background to the study. "These findings raise the concern that black patients receive inferior end-of-life care, a possibility underscored by disparities between black patients and white patients in certain objective care measures, such as pain management."
Jennifer W. Mack, M.D., M.P.H., of the Dana-Farber Cancer Institute, Boston, and colleagues studied 332 patients who were recruited between October 2002 and September 2007, were self-identified as non-Hispanic white or black, had cancer with distant metastases with failure of first-line chemotherapy, were 20 years of age or older and died during the course of the study.
The authors found that black patients reported similar rates of end-of-life discussions to white patients, but were less aware that their illness was terminal. Compared with white patients who had not had end-of-life discussions with their healthcare clinician, those that had end-of-life discussions tended to have a shorter survival time from baseline assessment. Additionally, the authors found that compared with black patients with fewer years of education, black patients with more education were marginally more likely to report having end-of-life discussions with their physician.
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