Health Policy & Management: Faculty Publications (2006-2018)

The Influence of Race on End-of-Life Choices Following a Counselor-Based Palliative Consultation

Document Type

Article

Publication Date

2-1-2015

Publication Title

American Journal of Hospice and Palliative Medicine

DOI

10.1177/1049909113506782

ISSN

1938-2715

Abstract

Black Americans are more likely than whites to choose aggressive medical care at the end of life. We present a retrospective cohort study of 2843 patients who received a counselor-based palliative care consultation at a large US southeastern hospital. Before the palliative consultation, 72.8% of the patients had no restrictions in care, and only 4.6% had chosen care and comfort only (CCO). After the consult, these choices dramatically changed, with only 17.5% remaining full code and 43.3% choosing CCO. Both before and after palliative consultation, blacks chose more aggressive medical care than whites, but racial differences diminished after the counselor-based consultation. Both African American and white patients and families receiving a counselor-based palliative consultation in the hospital make profound changes in their preferences for life-sustaining treatments.

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