Stephanie Milton

“Let me pray about it!”: The Role of Faith and Agency for Black Patients Contemplating Critical Medical Decisions

Stephanie Milton

University of California, Davis

smilton@ucdavis.edu

In the United States, older individuals belonging to cultural and ethnic minorities face significant barriers in accessing and choosing palliative or end-of-life care services. A substantial proportion of Black patients exhibit shorter durations of hospice care utilization, opting for more frequent hospitalizations instead. These communities suffer diminished quality of life at the end of their lives and physical, emotional, and financial hardships that impact the subsequent generation. Spirituality has been acknowledged as a coping mechanism for terminally ill patients and a determinant of participation in advanced care planning. Nevertheless, there is a dearth of data on the reasons and timing for minoritized individuals to engage in religious practices and prayer in these contexts, as well as the potential impact of these actions on decision-making procedures. African Americans constitute one of the most devout ethnic groups in the United States, with 93% holding a belief in a higher power, such as God or a superior being. Both medical and spiritual clinicians would be better served by having cultural competence and comfort and engaging their patients in these spaces. The proposed research paper explores the interconnectedness of faith, religiosity, and health equity. It focuses on the dynamics between African Americans who draw upon their religious beliefs when facing power imbalances during end-of-life discussions and their medical providers. The study aims to learn how Black people's faith gives them hope and agency when making critical medical decisions. The research will be conducted through focus groups and semi-structured interviews with Black people who claim to hold faith beliefs residing in urban and rural areas of Northern California. Black life and culture in Northern California are not as well-known as in other parts of the United States. There is not much published data about healthcare obstacles faced by Black older adults in this region. Yet the acute, palliative, and hospice needs of these communities are parallel to those of their counterparts in other states. I seek to bring more attention to the beliefs and needs of these groups to support increased health access and outcomes well before end-of-life decisions need to be made."

BIOGRAPHY

Stephanie Milton is a PhD candidate specializing in American Religious Cultures with an emphasis on medical humanities within the Study of Religion at the University of California, Davis. She also holds a Graduate Academic Unit Certificate in Family Caregiving from the Betty Irene Moore School of Nursing at UC Davis Health. Stephanie has worked as a hospital chaplain, with experience in behavioral health and palliative care in the Atlanta Veterans Affairs Healthcare System, acute and surgical care at Emory University Healthcare, and as a pediatric and geriatric hospice chaplain in home-based care environments. Her research interests include the confluence between religion, ethnicity, and bioethics, the impact of spiritual and moral harm, and grassroots organizations focusing on health equity. She holds a Master of Arts in Political Science from Washington University in St. Louis and a Master of Divinity from Candler School of Theology at Emory University. Stephanie is an ordained minister in the United Church of Christ.