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To the Editor: The study on religious coping and use of intensive life-prolonging care near death in patients with advanced cancer by Dr Phelps and colleagues¹ showed that positive religious coping was associated with receipt of intensive life-prolonging medical care near death. The instrument used to measure positive religious coping, the Brief RCOPE,² presupposes an image of God as someone who personally interacts with people. However, empirical research in several countries outside the United States indicates that many people have a nonpersonal image of God.^3-4

Adherence to a nonpersonal image of God could result in a very different coping style, with more acceptance at the end of life and without life-prolonging medical care. Therefore, when discussing prognosis and treatment options with terminally ill patients, clinicians should not just examine whether patients adhere to a positive religious coping style but should explore their religious beliefs and values in a more balanced . . . [Full Text of this Article]

Hanneke W. M. van Laarhoven, MD, PhD
h.vanlaarhoven@onco.umcn.nl
Department of Medical Oncology
Radboud University Nijmegen Medical Centre
Nijmegen, the Netherlands

Johannes Schilderman, PhD
Department of Empirical Theology
Radboud University Nijmegen
Nijmegen

Judith Prins, PhD
Department of Medical Psychology
Radboud University Nijmegen Medical Centre

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