Guilt and shame – not hope for recovery – are among the most common reasons terminally ill cancer patients continue with minimally beneficial treatments at the end of life, according to Rutgers researchers. “In the United States, advanced illness care is enveloped in a set of moralized social attitudes around ‘fighting’ and ‘not giving up,’ where death is seen as the enemy, to be fought off at all costs,” said Login S. George, a health services researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research, research member of the Cancer Prevention and Control Program at Rutgers Cancer Institute and lead author of the study published in the journal Health Psychology.
“This creates a dilemma for patients, who can feel like they are falling short of some moral code and disappointing others if they consider discontinuation of treatments,” George said. “Ours is among the first studies to quantify these sentiments.”
To assess end-of-life decision-making in terminally ill cancer patients, George and colleagues recruited 116 people receiving treatment at the Rutgers Cancer Institute, the state’s only NCI-designated Comprehensive Cancer Center, and other clinical sites between April 2022 and March 2024. Eligible participants had a median life expectancy of less than 12 months and were in the advanced stages of one of several cancers, including pancreatic, lung, colorectal or breast. To read the full story.