Religiosity is not a significant factor in caregivers’ palliative care choices except in one area: belief in miracles. So finds new research by a group of theologians and scientists.

In what the researchers call the first study of its kind, religious and spiritual beliefs did not significantly affect the choices made by surrogate decision makers for people requiring end-of-life care. Yet when the surrogate decision-maker believed that a miracle might change the course of their loved one’s illness, they were significantly more likely to choose aggressive medical treatment. They were also less accepting of a comfort-focused care plan, said Alexia Torke, M.D., from the Regenstrief Institute, Indianapolis.

A majority of the surrogate decision makers (59%) who participated in the study reported that they believed a miracle might save the patient. 

Earlier studies have found that religious patients tend to want – and receive – more aggressive, life-sustaining treatments. But Torke, a palliative care physician, said she’s found that caregivers with strong religious beliefs are just as likely to choose aggressive measures as they are hospice care and DNR status. “I wasn’t surprised that our study found a lack of association of most aspects of religiosity and spirituality with end-of-life decisions,” she said. “But I was surprised at how dramatically belief in miracles stood out.”

Torke said she conducted the study to help clinicians navigate the decision-making process with surrogate decision makers. When there is a disagreement about the value of continuing or discontinuing life-sustaining treatments, chaplains may help clinicians gain a deeper understanding of how the family member feels. They can also support and counsel the surrogate through difficult decision making, she concluded.

Study participants were predominantly Protestant Christians. Dr. Torke plans to conduct a future investigation with a more religiously diverse population. 

The study, “The Association of Surrogate Decision Makers’ Religious and Spiritual Beliefs with End of Life Decisions” was published in the Journal of Pain and Symptom Management.