We appreciate the thoughtful letter from Dr Kuschner and welcome the opportunity to continue the conversation about racial disparities in end-of-life care. Dr Kuschner asks how a physician's race might influence communication and a patient's preferences for end-of-life care. Previous reports have suggested that a racial match between patients and physicians might well affect clinical interactions and medical decision making.1,2 Unfortunately, no black physicians were involved in the care of the patients in our study. As a result, we are unable to test this interesting hypothesis. Moreover, our finding that black patients were more likely than white patients to prefer and receive aggressive end-of-life care cannot be explained by preferences for more aggressive care among black physicians.
Mack JW, Paulk E, Viswanath K, Prigerson HG. Racial Disparities in End-of-Life Care—Reply. Arch Intern Med. 2011;171(10):941-954. doi:10.1001/archinternmed.2011.196