Cultural Influences on End-of-Life Care

Study Notes

The U.S. model of health care, which values autonomy in medical decision making, is not easily applied to members of some racial or ethnic groups.
Cultural factors strongly influence patients' reactions to serious illness and decisions about end-of-life care.
Research has identified three basic dimensions in end-of-life treatment that vary culturally: communication of "bad news"; locus of decision making; and attitudes toward advance directives and end-of-life care.
In contrast to the emphasis on "truth telling" in the United States, it is not uncommon for health care professionals outside the United States to conceal serious diagnoses from patients, because disclosure of serious illness may be viewed as disrespectful, impolite, or even harmful to the patient.
Similarly, with regard to decision making, the U.S. emphasis on patient autonomy may contrast with preferences for more family-based, physician-based, or shared physician- and family-based decision making among some cultures.
Lower rates of advance directive completion among patients of specific ethnic backgrounds, which may reflect distrust of the U.S. health care system, current health care disparities, cultural perspectives on death and suffering, and family dynamics, may be attributable to the U.S. model of health care.

Description

This quiz explores how cultural factors impact patients' reactions to serious illness, decision making at the end of life, and attitudes toward advance directives and end-of-life care. It also delves into the contrast between the U.S. model of health care and practices in other countries on truth-telling and decision-making processes.