"The studies published to date have not convincingly established that death can be postponed through force of will or hastened by the loss of the desire to live," say Judith A. Skala, R.N., Ph.D., and Kenneth E. Freedland, Ph.D., of Washington University School of Medicine.
Available research is contradictory, shows only modest effects and is often of poor quality, Skala and Freedland say. In many cases, these studies also fail to explain any mechanisms that would delay or advance death.
Their review appears in the May issue of the journal Psychosomatic Medicine.
This hypothesis, first presented in a sociology journal 30 years ago, suggested that people who would have otherwise died can will themselves to stay alive in order to experience some personally or culturally meaningful event. But the idea doesn't hold up after a close look at the body of evidence in this literature.
For instance, one study claimed that there was a 19 percent dip in deaths among prominent Americans in the month before their birthdays and a 14 percent rise in the month afterward. However, Skala and Freedland say, the original authors include the birth month itself in the "after" category. That meant that some of the "post-birthday" deaths may have occurred before the actual birthday.
Another study of natural death, suicides and homicides in Philadelphia in 1982 found near-chance rates of death in the one-, two- and three-month periods around the birthdays of the dead.
Two studies analyzed the deaths of members of certain religious groups before and after their major holidays. A study of Catholic priests found no variation in mortality around Christmas, Easter, birthdays or anniversaries of their ordination. Another found a dip in deaths before and a rise after Christmas, but no such pattern around Easter.
Other researchers claimed a 20 percent rise in deaths after Christmas. A closer look at their data found that the rise really began five days before the holiday and the death rate on Christmas itself was higher than the average rate for the preceding or following weeks.
Similarly, one study concluded that deaths among Jewish men were more likely to show a dip before and a rise after Passover, while another study found just the opposite pattern. And a study in Israel found no patterns around major holidays at all, either among Jews or non-Jewish Israelis.
Writing in the same issue of Psychosomatic Medicine, Gary Smith, Ph.D., of Pomona College analyzed Asian-American deaths in relation to the Harvest Moon Festival. The Harvest Moon Festival is celebrated in the fall by Chinese, Koreans and Vietnamese.
Only one or two subgroups showed any significant variation from pure chance, and then only by pushing the day of the festival into the "after-the-festival" category.
But thinking of the festival day as falling after the festival makes no sense, Smith says, because the central ritual--a ceremonial meal--happens late that night.
"If a person is really able to postpone death until after the celebration of an important ceremonial occasion, shouldn't she be able to postpone death until after the main ceremonial activity?" Smith asks.
How individuals are supposed to control the advance or delay of death is an often-unanswered question, too. Some authors cite "stress reactions" or the benefits of "social support," but offer few details.
Future studies will have to be better designed to find valid answers, Skala and Freedland say. That means matching patients with similar illnesses to eliminate a major variable; learning how patients actually feel about birthdays and religious holidays, rather than assuming their significance; and including useful data on possible psychosomatic mechanisms that could tie the calendar to their time of death.
"Until then," they say, "speculation will undoubtedly continue about the differences between people who seem to lose steam near the end of a race and those who appear to find one last, impossible spurt of strength within themselves."
BY AARON LEVIN, SCIENCE WRITER
HEALTH BEHAVIOR NEWS SERVICE
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