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Editor's Correspondence
May 23, 2011

Racial Disparities in End-of-Life Care—Reply

Author Affiliations

Author Affiliations: Department of Pediatric Oncology and Center for Outcomes and Policy Research (Dr Mack), Center for Community-Based Research (Dr Viswanath), and Center for Psycho-oncology and Palliative Care Research (Dr Prigerson), Dana-Farber Cancer Institute, Department of Medicine, Children's Hospital (Dr Mack), and Department of Society, Human Development, and Health, Harvard School of Public Health (Dr Viswanath), Boston, Massachusetts; and Palliative Care Service, Southwestern Medical Center, University of Texas (Dr Paulk), Dallas.

Arch Intern Med. 2011;171(10):941-954. doi:10.1001/archinternmed.2011.196

In reply

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.

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