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Patients' diverse beliefs about what happens at the time of death§

Authors

  • Henry S. Perkins MD,

    Corresponding author
    1. Department of Medicine, The University of Texas Health Science Center, San Antonio, Texas
    • MD, Division of General Medicine, Department of Medicine, The University of Texas Health Science Center, PO Box 1696, Dearborn, MI 48121-1696
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    • We presented these data at the annual meeting of the Southern Region, Society of General Internal Medicine, Atlanta, Georgia, March 2006; the Eighth Annual David C. Thomasma International Bioethics Retreat, Freije Universitat, Amsterdam, the Netherlands, June 2006; the Fifth International Conference on Clinical Ethics and Ethics Consultation, Taichung, Taiwan, March 2009; and the annual conference of the European Association of Centres of Medical Ethics, Venice, Italy, September 2009. The data were also accepted for presentation at the national meeting, Society of General Internal Medicine, Los Angeles, California, April 2006. This work was supported with resources from the Audie L. Murphy Veterans Administration Medical Center, San Antonio, Texas, but the views expressed here do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States Government. The following institutions helped fund the research either directly or indirectly: The Department of Veterans Affairs; The John A. Hartford Foundation; the American Federation on Aging Research; and the Mexican-American Medical Treatment Effectiveness Research Center, the Aging Research and Education Center, and the Medical Dean's Office, all at The University of Texas Health Science Center at San Antonio. Funders played no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, and approval of the manuscript. The authors have no financial conflict of interests.

  • Josie D. Cortez MA,

    1. Intercultural Development Research Association, San Antonio, Texas
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  • Helen P. Hazuda PhD

    Corresponding author
    1. Department of Medicine, The University of Texas Health Science Center, San Antonio, Texas
    2. Research Service, Department of Veterans Affairs Audie L. Murphy Medical Center, San Antonio, Texas
    • Helen P. Hazuda, PhD, c/o Division of Clinical Epidemiology, Department of Medicine, The University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78229-3900
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    • Telephone: 210-567-6678; Fax: 210-567-1990


  • This work was supported with resources from the Audie L. Murphy Veterans Administration Medical Center, San Antonio, Texas, but the views expressed here do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

  • §

    The following institutions helped fund the research either directly or indirectly: The Department of Veterans Affairs; The John A. Hartford Foundation; the American Federation on Aging Research; and the Mexican-American Medical Treatment Effectiveness Research Center, the Aging Research and Education Center, and the Medical Dean's Office, all at The University of Texas Health Science Center at San Antonio. Funders played no role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; or the preparation, review, and approval of the manuscript. The authors have no financial conflict of interests.

  • Tel.: 313-722-4689

Abstract

BACKGROUND:

Beliefs about what happens at the time of death surely affect a patient's whole dying experience and could help guide end-of-life care. Yet virtually no research describes those beliefs. This exploratory study begins the descriptive process.

METHODS:

Assuming culture is key, we interviewed 26 Mexican-American (MA), 18 Euro-American (EA), and 14 African-American (AA) inpatients about their beliefs concerning what happens at the time of death.

RESULTS:

One belief, that death separates the dead from the living, was widespread. Majorities of all 3 ethnic group samples and of 5 of the 6 gender subsamples expressed this belief, saying the dead “go” or “leave” from this life. Other beliefs differed by ethnic group or gender. For example, more EAs (50%) than others said death is a momentary event, and more MAs (35%) than others said death involves “being taken” by an external force (always God or Jesus). Furthermore, considerably more EA women (45%) than others said some senses persist after death. In contrast, the physiologic signs that participants cited as defining the exact time of death varied from individual to individual with no ethnic or gender pattern, and no one sign predominated.

CONCLUSIONS:

A few beliefs about what happens at the time of death may characterize Americans in general; many other beliefs may characterize only certain ethnic groups, genders, or individuals. To identify such beliefs and to use them to guide end-of-life care, hospitalists and other health professionals may have to elicit them directly from patients or survivors. Journal of Hospital Medicine 2012. © 2011 Society of Hospital Medicine

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