Journal of General Internal Medicine

, Volume 34, Issue 10, pp 1981–1983 | Cite as

Differences by Race, Religiosity, and Mental Health in Preferences for Life-Prolonging Treatment Among Medicare Beneficiaries

  • Justin J. SandersEmail author
  • Anna I. Berrier
  • Léonce Nshuti
  • James A. Tulsky
  • Charlotta Lindvall
Concise Research Reports


Patient preferences ought to guide clinical decision-making, particularly in serious illnesses where disease-directed therapies are not always effective and may cause additional suffering. Yet, clinicians commonly struggle to engage seriously ill patients and their families in conversations about treatment preferences,1 and may leave these conversations still unaware of patients’ wishes.2 When compared to Whites, African Americans may have different end-of-life (EOL) care preferences, which may impact the degree to which they are honored.3 We lack understanding about how widespread differences in preferences are. Better population-level data on patient preferences may help prepare clinicians for such discussions about goals of care.


We used the National Health and Aging Trends Study (NHATS) to assess predictors of EOL treatment preference in two hypothetical scenarios.4NHATS, a longitudinal cohort study of a nationally representative sample of Medicare...



The authors thank Dr. Simo Goshev of IQSS Harvard University for statistical support.

Funding Information

The authors received funding for this project through the Sojourns Scholars Program to Dr. Sanders from the Cambia Health Foundation, as well as the American Academy of Hospice and Palliative Medicine Research Scholars Program.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Justin J. Sanders
    • 1
    • 2
    Email author
  • Anna I. Berrier
    • 1
    • 3
  • Léonce Nshuti
    • 1
    • 4
  • James A. Tulsky
    • 1
    • 2
  • Charlotta Lindvall
    • 1
    • 2
  1. 1.Department of Psychosocial Oncology and Palliative Care Dana-Farber Cancer InstituteBostonUSA
  2. 2.Division of Palliative MedicineBrigham and Women’s HospitalBostonUSA
  3. 3.Department of Health Policy and ManagementUNC Gillings School of Global Public HealthChapel HillUSA
  4. 4.Department of BiostatisticsHarvard School of Public HealthBostonUSA

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