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
van Laarhoven HWM, Schilderman J, Prins J. Religious Coping and Life-Prolonging Care. JAMA. 2009;302(3):257–258. doi:10.1001/jama.2009.1003
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