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Blacks in that study tended to believe that "if God wants to take our lives, he will decide when and where that will happen," said Bayer, of the University of Rochester Medical Center.
Dr. Otis Brawley, a black physician in Atlanta and chief medical officer for the American Cancer Society, said the new findings "make sense."
"They play into all of my prejudices and they play into all of my personal experiences," Brawley said.
He said other reasons contribute to the phenomenon.
Because low-income minority patients often get less preventive medical care, they're less likely than whites to have long-term relationships with doctors, Brawley said. So physicians who treat them late in life may be strangers unwilling to "pull the plug" without knowing their wishes.
Also, Brawley said, black patients often have splintered families, and estranged relatives are in charge of making end-of-life decisions.
"They feel guilt about saying, 'Let this patient die,'" he said.
"The breakdown of the family in certain cultures contributes somewhat to this phenomenon," he said. "I've seen it so many times."
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