Racial Disparities in the Outcomes of Communication on Medical Care Received Near Death

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Abstract
Black patients receive more life-prolonging measures and less comfort-directed care at the end of life (EOL) than white patients.1-4 Previous studies have documented increased rates of resuscitation,2,4 intensive care unit hospitalization,4,5 and feeding tube use at the EOL among black patients1,4 and decreased rates of hospice care among black patients compared white patients.3,6,7 Although black patients are also more likely than white patients to desire life-prolonging measures,8-10 receipt of life-prolonging care at the EOL is associated with greater distress and with poorer quality of life.11 These findings raise the concern that black patients receive inferior EOL care, a possibility underscored by disparities between black patients and white patients in certain objective care measures, such as pain management.12-14

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