Miracles & medicine: How one’s belief in divine intervention impacts end-of-life care

First-of-its-kind study reveals that six in ten surrogates believe a miracle may save their loved one from a terminal ailment.

INDIANAPOLIS — In the event an individual is unable to make decisions for themselves due to a medical condition, it’s common for a close family member, friend, or loved one to serve as their surrogate. In these situations, the surrogate makes decisions on behalf of their loved one regarding any and all treatment options moving forward. Now, in a first of its kind study, researchers from the Regenstrief Institute in Indianapolis, Indiana have investigated how the religious and spiritual beliefs of surrogates influence how they approach end-of-life care for older adult family members.

The study’s main finding was that a surrogate’s beliefs regarding the possibility of a miracle is a significant factor in which treatments they select for their loved one. Surprisingly, aside from beliefs on miracles, a surrogate’s overall religious and spiritual beliefs were not found to influence their end of life care decisions all that much.

“If the surrogate decision maker believed that a miracle might occur and change the course of their loved one’s illness, the surrogate was more likely to choose aggressive treatment and was less accepting of a comfort-focused care plan,” explains study leader Dr. Alexia Torke in a release. “We found that belief in miracles was associated with the surrogate decision maker not wanting the patient to have DNR [do not resuscitate] code status. Patients were also less likely to receive hospice services.”

The research team believes it was important to investigate this topic because it is always helpful for the patient when the surrogate and medical team are on the same page regarding how to proceed with treatment. For example, if a doctor can’t seem to understand why an especially religious surrogate wants to pursue a particular avenue of treatment for their family member, researchers recommend bringing in a local spiritual advisor or clergy member to act as a mediator. In this way, the chaplain can help doctors better understand where the surrogate is coming from, while simultaneously supporting the surrogate during a time of difficult decision-making.

The majority of the surrogates (59%) who participated in the study reported that they believe a miracle may one day save their loved one. However, the research team were working with a local group of surrogates, and most identified themselves as Protestant Christians. Moving forward, Dr. Torke would like to conduct a nationally representative study with a more religiously diverse sample group.

“As a palliative care doctor, I see many family members with strong religious beliefs who want aggressive measures for their loved one and others with strong religiosity or spirituality who are comfortable accepting that their loved one is going to die,” Dr. Torke adds. “The surrogate might say something like, ‘She’ll go to heaven,’ or ‘She’ll be with God.’ So I wasn’t surprised that our study found a lack of association of most aspects of religiosity and spirituality with end-of-life decisions, but I was surprised at how dramatically belief in miracles stood out.”

The study is published in the Journal of Pain and Symptom Management.