Black and white patients may not receive the same end of life care, study finds

Racial disparities may exist between black and white patients who require end of life care, a new study finds. Although all study participants were helped by conversations with their physicians, black patients’ requests were not always taken into consideration.

Researchers asked 332 black and white patients with advanced cancer questions about their goals for end of life care, and whether they talked about these goals with their doctors. About 35% of black patients and about 38% of white patients said they had end of life discussions, but black patients were less aware than white patients of the fact that they were terminally ill.

More white patients than black preferred a care plan that included pain relief, with the risk that they may not live as long (called symptom-directed care), over treatment that extended life as much as possible. More white patients also had do-not-resuscitate orders in place than black patients.

Talks about end of life care with doctors resulted in some goals being met for black patients, but not all. Having do-not resuscitate instructions didn’t decrease the possibility that they’d get life-extending care, nor did it increase the chance they’d get the end of life treatments they requested.

In the study, the authors wrote that end of life discussions among patients with advanced stages of cancer are important, regardless of race. “Nonetheless,” they wrote, “more work is needed to identify ways to help black patients receive the same benefits of such [end of life] discussions as white patients.”

The study was published this week in Archives of Internal Medicine.

-- Jeannine Stein / Los Angeles Times