Importance of faith on medical decisions regarding cancer care.
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PURPOSE: Decisions regarding cancer treatment choices can be difficult. Several factors may influence the decision to undergo treatment. One poorly understood factor is the influence of a patient's faith on how they make medical decisions. We compared the importance of faith on treatment decisions among doctors, patients, and patient caregivers. METHODS: One hundred patients with advanced lung cancer, their caregivers, and 257 medical oncologists were interviewed. Participants were asked to rank the importance of the following factors that might influence treatment decisions: cancer doctor's recommendation, faith in God, ability of treatment to cure disease, side effects, family doctor's recommendation, spouse's recommendation, and children's recommendation. RESULTS: All three groups ranked the oncologist's recommendation as most important. Patients and caregivers ranked faith in God second, whereas physicians placed it last (P <.0001). Patients who placed a high priority on faith in God had less formal education (P <.0001). CONCLUSION: Patients and caregivers agree on the factors that are important in deciding treatment for advanced lung cancer but differ substantially from doctors. All agree that the oncologist's recommendation is most important. This is the first study to demonstrate that, for some, faith is an important factor in medical decision making, more so than even the efficacy of treatment. If faith plays an important role in how some patients decide treatment, and physicians do not account for it, the decision-making process may be unsatisfactory to all involved. Future studies should clarify how faith influences individual decisions regarding treatment. (+info)
Death and reductionism: a reply to John F Catherwood.
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This reply to John F Catherwood's criticism of brain-related criteria for death argues that brainstem criteria are neither reductionist nor do they presuppose a materialist theory of mind. Furthermore, it is argued that brain-related criteria are compatible with the majority of religious views concerning death. (+info)
The search for meaning: RU 486 and the law of abortion.
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The advent of RU 486 (mifepristone), a steroid analogue capable of inducing menses within 8 to 10 weeks of a missed menstrual period, has provoked a firestorm of concern and controversy. When used in conjunction with prostaglandin (RU 486/PG), it is at least 95% effective. Used in France principally to terminate confirmed pregnancies very early in the process of gestation, RU 486 raises many interesting legal questions. This article focuses on whether and how RU 486/PG can be accommodated within the framework of the world's current abortion laws. Four avenues are explored and conclusions drawn. First, it is clear that RU 486/PG can be used readily, if approved, within the regimens established by liberal abortion laws, as has been the experience in France, the United Kingdom, and even China. Second, although unlikely, the introduction of this new technology may inspire a reexamination of restrictive abortion statutes themselves. Third, some of the presently restrictive laws may be interpreted to permit RU 486/PG use as a legal procedure, for a very narrow range of reasons. Finally, in some settings the early use of RU 486/PG (before pregnancy can be confirmed) may fall outside the reach of abortion legislation and hence be acceptable from a legal point of view. (+info)
Do medical students have the knowledge needed to maximize organ donation rates?
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INTRODUCTION: The chronic shortage of organs for donation could be improved by increasing the numbers of potential and actual donors. Physicians can play a key role in solving this problem but may miss opportunities because they lack knowledge about organ donation to answer questions or concerns. Education of physicians early in their careers may lead to better procurement rates for donor organs. We carried out a study at Queen's University in Kingston, Ont., to determine whether medical students have sufficient knowledge of topics shown to affect organ donation rates. METHODS: Medical students from years 1-4 completed a self-administered questionnaire. Section 1 tested general knowledge about organ donation; section 2 tested the students' ability to identify potential donors; and section 3 dealt with the approach to the potential donor's family. Univariate predictors of mean test scores were assessed using the t-test. RESULTS: Of 322 medical students who received the questionnaire, 260 (81%) responded. The mean age of the students was 25 years and 54% were men. The mean knowledge score was 6.7 out of a possible score of 14. Third-year students had the best knowledge scores (7.6), followed by fourth- (7.4), second- (6.6) and first-year students (5.7). Teaching about organ donation and a student's comfort with approaching a family for organ donation were also predictive of higher knowledge scores. There was no correlation between knowledge score and age, gender or whether the student was carrying a signed donor card. Knowledge scores were low in all 3 sections. Thirty-six percent of students did not know that brain death means that the patient is dead rather than in a coma. Half the medical students believed that people of certain religious groups should not be approached about organ donation. CONCLUSIONS: Medical students possess limited knowledge about organ donation topics important for maximizing procurement rates. A teaching intervention designed to target these shortcomings may be beneficial. (+info)
African American church participation and health care practices.
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BACKGROUND: While religious involvement is associated with improvements in health, little is known about the relationship between church participation and health care practices. OBJECTIVES: To determine 1) the prevalence of church participation; 2) whether church participation influences positive health care practices; and 3) whether gender, age, insurance status, and levels of comorbidity modified these relationships. DESIGN: A cross-sectional analysis using survey data from 2196 residents of a low-income, African-American neighborhood. MEASUREMENTS: Our independent variable measured the frequency of church attendance. Dependent variables were: 1) Pap smear; 2) mammogram; and 3) dental visit-all taking place within 2 years; 4) blood pressure measurement within 1 year, 5) having a regular source of care, and 6) no perceived delays in care in the previous year. We controlled for socioeconomic factors and the number of comorbid conditions and also tested for interactions. RESULTS: Thirty-seven percent of community members went to church at least monthly. Church attendance was associated with increased likelihood of positive health care practices by 20% to 80%. In multivariate analyses, church attendance was related to dental visits (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.3 to 1.9) and blood pressure measurements (OR, 1.6; 95% CI, 1.2 to 2.1). Insurance status and number of comorbid conditions modified the relationship between church attendance and Pap smear, with increased practices noted for the uninsured (OR, 2.3; 95% CI, 1.2 to 4.1) and for women with 2 or more comorbid conditions (OR, 1.9; 95% CI, 1.1 to 3.5). CONCLUSION: Church attendance is an important correlate of positive health care practices, especially for the most vulnerable subgroups, the uninsured and chronically ill. Community- and faith-based organizations present additional opportunities to improve the health of low-income and minority populations. (+info)
Religious and nonreligious coping methods among persons with rheumatoid arthritis.
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OBJECTIVE: To examine religious and nonreligious coping methods among persons with rheumatoid arthritis (RA). To identify positive and negative religious coping methods and personal characteristics associated with them. METHODS: Persons with RA (n = 181) completed a religious coping questionnaire, 6 subscales from a nonreligious coping inventory, and a depression scale. RESULTS: Religious and nonreligious coping were moderately correlated. The scores of all positive religious coping subscales were positively related to the importance persons attributed to religion. Scores of all negative religious coping subscales were positively associated with self-reported depressive symptoms. CONCLUSIONS: Correlations of religious and nonreligious coping methods were neither completely independent of each other nor functionally redundant, suggesting that each made unique contributions to coping with RA. Persons with no (or few) depressive symptoms who reported that religion was important to them tended to make positive use of their religion as they coped with the emotional stress of RA. A significant number of self-reported depressive symptoms were correlated with a negative use of religion. (+info)
Did St Birgitta suffer from epilepsy? A neuropathography.
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Several famous religious personalities have been discussed as possibly having had epilepsy. Partial epileptic fits can be accompanied by religious experiences. The Swedish St Birgitta of Vadstena is focused on from this perspective as the exterior of the skull thought to belong to her has a prominent tuberculum with a corresponding interior indentation possibly indicating the previous existence of a meningioma, a well known cause of epilepsy. This article scrutinises arguments for and against the possibility of epileptic features in the revelations of the saint, as well as in her life story. (+info)
Religiosity is associated with hippocampal but not amygdala volumes in patients with refractory epilepsy.
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OBJECTIVE: To assess the relationship between the behavioural triad of hyper-religiosity, hypergraphia and hyposexuality in epilepsy, and volumes of the mesial temporal structures. METHOD: Magnetic resonance images were obtained from 33 patients with refractory epilepsy and mesial temporal structure volumes assessed. Amygdala and hippocampal volumes were then compared in high and low scorers on the religiosity, writing, and sexuality sub-scales of the Neurobehavioural Inventory. RESULTS: Patients with high ratings on the religiosity scale had significantly smaller right hippocampi. Religiosity scores rated by both patient and carer showed a significant negative correlation with right hippocampal volumes in this group. There were no other differences in amygdala or hippocampal volumes between these groups, or between high and low scorers on the writing and sexuality sub-scales. CONCLUSIONS: These findings suggest that right hippocampal volumes are negatively correlated with religiosity in patients with refractory epilepsy. (+info)