Strategies for culturally effective end-of-life care.

Full Abstract

As a result of profound worldwide demographic change, physicians will increasingly care for patients from cultural backgrounds other than their own. Differences in beliefs, values, and traditional health care practices are of particular relevance at the end of life. Health care providers and patients and families may not have shared understandings of the meaning of illness or death and may not agree on the best strategies to plan for the end of life or to alleviate pain and suffering. Good end-of-life care may be complicated by disagreements between physicians and patients, difficult interactions, or decisions the physician does not understand. Challenges may result from cultural differences between the patient's background and traditional medical practice. Values so ingrained in physicians as to be unquestioned may be alien to patients from different backgrounds. Physicians need to be sensitive to cultural differences and to develop the skills necessary to work with patients from diverse backgrounds. Community and cultural ties provide a source of great comfort as patients and families prepare for death. This paper describes two cases that raise issues about cross-cultural end-of-life practice and suggests strategies for negotiating common problems. Physicians should assess the cultural background of each patient and inquire about values that may affect care at the end of life. They should become aware of the specific beliefs and practices of the populations they serve, always remembering to inquire whether an individual patient adheres to these cultural beliefs. Attention to cultural difference enables the physician to provide comprehensive and compassionate palliative care at the end of life.

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Author information

Author/s: Crawley, LaVera M (LM); Marshall, Patricia A (PA); Lo, Bernard (B); Koenig, Barbara A (BA); End-of-Life Care Consensus Panel;

Affiliation: Stanford University Center for Biomedical Ethics, 701 Welch Road, Suite 1105, Palo Alto, CA 94304, USA.

Grants: R01 NR029060 (Agency:United States NINR)

Journal and publication information

Publication Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.

Journal: Annals of internal medicine (Ann Intern Med), published in United States. (Language: eng)

Reference: 2002-May; vol 136 (issue 9) : pp 673-9

Dates: Created 2002/05/06; Completed 2002/05/16; Revised 2007/11/14;

PMID: 11992303, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Advance Directives
Aged
Cultural Diversity
Decision Making
Family - psychology
Female
Humans

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