Skip to main content
SpringerLink
Log in

Preferences for Life-Prolonging Medical Treatments and Deference to the Will of God

  • Original Paper
  • Published:
Journal of Religion and Health Aims and scope Submit manuscript

Abstract

We defined and measured a dimension of religiosity frequently invoked in end-of-life (EOL) research—deference to God’s Will (GW)—and examined its relationship to preferences for life-prolonging treatments. In a 35-min telephone interview, 304 older men and women (60 +) were administered the 5-item GW scale, sociodemographic questions, three attitude items regarding length of life, and measures of two health indices, depression, and life-prolonging treatment preferences. The GW scale demonstrated internal consistency (Cronbach’s alpha = .94) and predictive and discriminant validity. Higher scores indicative of greater deference to GW were associated with stronger life-prolonging treatment preferences in poor-prognosis scenarios. Implications for the role of religiosity in medical decision-making are discussed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Annas, G. J. (2005). “Culture of life” politics at the bedside—The case of Terri Schiavo. New England Journal of Medicine, 352, 1710–1715.

    Article  CAS  PubMed  Google Scholar 

  • Carmel, S., & Mutran, E. (1997). Preferences for different life-sustaining treatments among elderly persons in Israel. Journal of Gerontology B: Psychological and Social Sciences, 52, S97–S102.

    CAS  Google Scholar 

  • Cicirelli, V. G., MacLean, A. P., & Cox, L. S. (2000). Hastening death: A comparison of two end-of-life decisions. Death Studies, 5, 401–409.

    Google Scholar 

  • Cohen-Mansfield, J., Droge, J. A., & Billig, N. (1992). Factors influencing hospital patients’ preferences in the utilization of life-sustaining treatments. The Gerontologist, 32, 89–95.

    CAS  PubMed  Google Scholar 

  • Contrada, R. J., Goyal, T. M., Cather, C., Rafalson, L., Idler, E. L., & Krause, T. J. (2004). Psychosocial factors in outcomes of heart surgery: The impact of religious involvement and depressive symptoms. Health Psychology, 23, 227–238. doi:10.1037/0278-6133.23.3.227.

    Article  PubMed  Google Scholar 

  • Coppola, K. M., Bookwala, J., Ditto, P. H., Lockhart, L. K., Danks, J. H., & Smucker, W. D. (1999). Elderly adults’ preferences for life-sustaining treatment: The role of impairment, prognosis, and pain. Death Studies, 23, 617–634. doi:10.1080/074811899200803.

    Article  CAS  PubMed  Google Scholar 

  • Degelman, D., & Lynn, D. (1995). The development and preliminary validation of the Belief in Divine Intervention Scale. Journal of Psychology and Theology, 23, 37–44.

    Google Scholar 

  • Duffy, S. A., Jackson, F. C., Schim, S. M., Ronis, D. L., & Fowler, K. E. (2005). Racial/ethnic preferences, sex preferences, and perceived discrimination related to end-of-life care. Journal of the American Geriatrics Society, 54, 150–157. doi:10.1111/j.1532-5415.2005.00526.x.

    Article  Google Scholar 

  • Fetzer Institute. (1999). Multidimensional measurement of religiousness/spirituality for use in health research: A report of the Fetzer Institute/National Institute on Aging Working Group. Kalamazoo, MI: Fetzer Institute.

    Google Scholar 

  • Gorsuch, R. L., & Smith, C. S. (1983). Attributions of responsibility to God: An interaction of religious beliefs and outcomes. Journal for the Scientific Study of Religion, 22, 340–352. doi:10.2307/1385772.

    Article  Google Scholar 

  • Gostin, L. W. (1997). Deciding life and death in the courtroom: From Quinlan to Cruzan, Glucksberg, and Vacco–A brief history and analysis of constitutional protection of the ‘right to die’. Journal of the American Medical Association, 278, 1523–1528. doi:10.1001/jama.278.18.1523.

    Article  CAS  PubMed  Google Scholar 

  • Gostin, L. W. (2005). Ethics, the constitution, and the dying process: The case of Teresa Marie Schiavo. Journal of the American Medical Association, 293, 2403–2407. doi:10.1001/jama.293.19.2403.

    Article  CAS  PubMed  Google Scholar 

  • Heeren, O., Menon, A. S., Raskin, A., & Ruskin, P. (2001). Religion and end of life treatment preferences among geriatric patients. International Journal of Geriatric Psychiatry, 1, 203–208. doi :10.1002/1099-1166(200102)16:2<203::AID-GPS306>3.0.CO;2-M.

    Article  Google Scholar 

  • Helode, R. D., & Barlinge, S. P. (1984). Locus of control in relation to religiosity and sex. Psychological Studies, 29, 71–72.

    Google Scholar 

  • Hill, P. C., & Hood, R. W. (Eds.). (1999). Measures of religiosity. Birmingham, AL: Religious Education Press.

    Google Scholar 

  • Hill, P. C., & Pargament, K. I. (2003). Advances in the conceptualization and measurement of religion and spirituality. The American Psychologist, 58, 64–74. doi:10.1037/0003-066X.58.1.64.

    Article  PubMed  Google Scholar 

  • Idler, E. L. (1987). Religious involvement and health of the elderly: Some hypotheses and an initial test. Social Forces, 97, 1052–1079.

    Google Scholar 

  • Johnson, K. S., Elbert-Avila, K. I., & Tulsky, J. A. (2005). The influence of spiritual beliefs and practices on the treatment preferences of African Americans: A review of the literature. Journal of the American Geriatrics Society, 53, 711–719. doi:10.1111/j.1532-5415.2005.53224.x.

    Article  PubMed  Google Scholar 

  • Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged. The Index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914–919.

    CAS  PubMed  Google Scholar 

  • Krause, N., & Tran, T. V. (1989). Stress and religious involvement among older blacks. Journal of Gerontology: Social Sciences, 44, S4–S13.

    CAS  Google Scholar 

  • Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.

    CAS  PubMed  Google Scholar 

  • Lawton, M. P., Moss, M., Fulcomer, M., & Kleban, M. H. (1982). A research and service oriented multilevel assessment instrument. Journal of Gerontology, 37, 91–99.

    CAS  PubMed  Google Scholar 

  • Levenson, H. (1974). Differentiating among internality, powerful others, and chance. In H. M. Lefcourt (Ed.), Research with the locus of control construct (Vol. 1, pp. 15–63). New York: Academic Press.

    Google Scholar 

  • Levin, J. S. (1996). How religion influences morbidity and health: Reflections on natural history, salutogenesis and host resistance. Social Science and Medicine, 43, 849–864.

    Article  CAS  PubMed  Google Scholar 

  • Levin, J. S., Taylor, R. J., & Chatters, L. M. (1994). Race and gender differences in religiosity among older adults: Findings from four national surveys. Journal of Gerontology: Social Sciences, 49, S137–S145.

    CAS  Google Scholar 

  • McCullough, M. E., Hoyt, W. T., Larson, D. B., Koenig, G., & Thoresen, C. (2000). Religious involvement and mortality: A meta-analytic review. Health Psychology, 5, 1–6.

    Google Scholar 

  • McInroy, A. (2005). Blood transfusion and Jehovah’s Witnesses: The legal and ethnical issues. British Journal of Nursing, 14, 270–274.

    PubMed  Google Scholar 

  • Muramoto, O. (1998). Bioethics of the refusal of blood by Jehovah’s witnesses: Part 1. Should bioethical deliberation consider dissidents’ views? Journal of Medical Ethics, 24, 223–230.

    Article  CAS  PubMed  Google Scholar 

  • Nam, C. B., & Terrie, E. W. (1988). 1980-Nam-Powers occupational status scores. Working Paper 88-48. Center for the Study of Populations, Florida State University.

  • Pargament, K. I. (1999a). Meaning. In Fetzer Institute. Multidimensional measurement of religiousness/spirituality for use in health research: A report of the Fetzer Institute/National Institute on Aging Working Group. Kalamazoo, MI: Fetzer Institute.

    Google Scholar 

  • Pargament, K. I. (1999b). Religious/spiritual coping. In Fetzer Institute. Multidimensional measurement of religiousness/spirituality for use in health research: A report of the Fetzer Institute/National Institute on Aging Working Group. Kalamazoo, MI: Fetzer Institute.

    Google Scholar 

  • Pope John Paul II. (2004). Life-sustaining treatment and vegetative state: Scientific advances and ethnical dilemmas. Issues in Law and Medicine, 20, 167–170.

    Google Scholar 

  • Powell, L. H., Shahabi, L., & Thoresen, C. E. (2003). Religion and spirituality: Linkages to physical health. American Psychologist, 58, 36–52.

    Article  PubMed  Google Scholar 

  • Quill, T. E. (2005). Terri Schiavo—A tragedy compounded. New England Journal of Medicine, 352, 1630–1633.

    Article  CAS  PubMed  Google Scholar 

  • Ritzema, R., & Young, C. (1983). Causal schemata and the attribution of supernatural causality. Journal of Psychology and Theology, 11, 35–43.

    Google Scholar 

  • Roccaforte, W. H., Burke, W. J., Bayer, B. L., & Wengel, S. P. (1992). Validation of a telephone version of the Mini-Mental State Examination. Journal of the American Geriatrics Society, 40, 697–702.

    CAS  PubMed  Google Scholar 

  • Rotter, J. B. (1966). Generalized expectancies for internal versus external control of reinforcement. Psychological Monographs, 80, 1. (Whole No. 609).

    CAS  PubMed  Google Scholar 

  • Schneiderman, L. J., Pearlman, R. A., Kaplan, R. M., Anderson, J. P., & Rosenberg, E. M. (1992). Relationship of general advance directive instructions to specific life-sustaining treatment preferences in patients with serious illness. Archives of Internal Medicine, 152, 2114–2122.

    Article  CAS  PubMed  Google Scholar 

  • Strawbridge, W. J., Shinn, S. J., Cohen, R. D., Roberts, R. E., & Kaplan, G. A. (1998). Religiosity buffers effects of some stressors on depression but exacerbates others. Journal of Gerontology: Social Sciences, 53B, S118–S126.

    Google Scholar 

  • Underwood, L. G. (1999). Daily spiritual experiences. In Fetzer Institute. Multidimensional measurement of religiousness/spirituality for use in health Research: A report of the Fetzer Institute/National Institute on Aging Working Group. Kalamazoo, MI: Fetzer Institute.

    Google Scholar 

  • Welton, G. L., Adkins, A. G., Ingle, S. L., & Dixon, W. A. (1996). God control: The fourth dimension. Journal of Psychology and Theology, 24, 13–25.

    Google Scholar 

  • Winter, L., Lawton, M. P., & Ruckdeschel, K. (2003). Preferences for prolonging life: A prospect theory approach. The International Journal of Aging and Human Development, 56, 155–170.

    Article  Google Scholar 

  • Wreen, M. (1982–1983). J. Skelly Wright and refusal of treatment. Journal of Bioethics, 4, 11–28.

  • Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., et al. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Applied Research on Aging and Health, Thomas Jefferson University, Edison Building, suite 500, 130 South 9th Street, Philadelphia, PA, 19107, USA

    Laraine Winter, Marie P. Dennis & Barbara Parker

Authors
  1. Laraine Winter
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marie P. Dennis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara Parker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Laraine Winter.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Winter, L., Dennis, M.P. & Parker, B. Preferences for Life-Prolonging Medical Treatments and Deference to the Will of God. J Relig Health 48, 418–430 (2009). https://doi.org/10.1007/s10943-008-9205-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10943-008-9205-y

Keywords

Search

Navigation