Religious coping in dying patients

In downtown Los Angeles recently, two very different celebrations went on within walking distance of each other.

On West Temple Street, at the beautiful and contemporary Cathedral of Our Lady of the Angels—a structure with no right angles in its adobe-colored walls—Catholic Mass was offered throughout the morning, in both English and Spanish. Five blocks south, at the stunningly refurbished Millenium Biltmore Hotel on Grand Avenue, the Council for Secular Humanism, whose stated mission is, in part, “to advocate and defend a nonreligious life stance,” was celebrating its 30th Anniversary, with a lineup of speakers that included prominent atheist author Richard Dawkins. The Secular Humanism gathering was sold out; admission to the Cathedral was free.

It would be hard to find two more contradictory congregations anywhere in the country (okay, maybe a UCLA/USC game, but that’s religion of a different stripe). Yet every single attendee at either location had, whether they like it or not, one thing in common: they will all die. The only difference is that some of them will die believing in God, and some will die in disbelief. But die they all will.

A huge chunk of narrative medicine literature deals with death and dying; a future literary prescription of The Literary Doctor will consider Leo Tolstoy’s The Death of Ivan Ilyitch, a novella describing in excruciating detail the fatal illness of a Russian parvenu whose religious indifference gives way to belief and rapture in his final hours.

But do contemporary atheists have the kind of deathbed conversions so rife in traditional literature? Will new age atheists like Richard Dawkins and Sam Harris cry out to Jesus as their blood pressure falls and their lungs fill with fluid? I think not.

During a quarter-century of providing medical care to patients with kidney failure, I have attended numerous dying patients and witnessed dozens of deaths. I recall no eleventh-hour conversions. Nowadays, there are atheists in foxholes. For the most part, it appears to me that the spiritual beliefs or disbeliefs patients hold throughout their lives are the beliefs they leave this world with. The atheists among us do not flinch, nor do the religious renounce God in anger over their disease.

So, are the deaths of those who die believing in God different in any way from those who die in disbelief? The answer is a qualitative yes.

One large study found that positive religious coping improved patients’ psychological adjustment to major illness by affording them a sense of meaning, control, and personal growth.

But another later study concluded that while all the above is true, positive religious coping in patients with advanced cancer resulted in higher utilization of intensive life support at the end of life, with no gain in survival.

The faithful appear to die happier and better adjusted than atheists, but harder.

My personal observations agree with these findings. I have been impressed at how well some of my more deeply spiritual patients are able to endure the horrific diseases they are afflicted with, while detecting in some of my secular humanists a slight whiff of stunned fatalism. Sometimes, though, the religious don’t know when to quit.

Now it’s your turn. What are your thoughts on dying without God?

Richard Barager is a nephrologist who blogs at The Literary Doctor.

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