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Medline ® Abstracts for References 34,37

of 'Advance care planning and advance directives'

34
TI
The influence of culture on end-of-life decision making.
AU
Bullock K
SO
J Soc Work End Life Palliat Care. 2011;7(1):83-98.
 
In their research, scholars have documented racial and ethnic differences in end-of-life care preferences, which have translated into cultural barriers. However, few studies have explained the racial differences. In the present study, focus groups with semi-structured follow-up interviews were utilized to elicit explanations for variance in decision making in a sample of Black and White community-dwelling residents. Participants identified specific cultural beliefs, values, and communication patterns that can be used to promote cultural competency among practitioners who provide care at end of life.
AD
Department of Social Work, North Carolina State University, Raleigh, NC, USA. kbulloc@ncsu.edu
PMID
37
TI
Ethnicity and attitudes towards life sustaining technology.
AU
Blackhall LJ, Frank G, Murphy ST, Michel V, Palmer JM, Azen SP
SO
Soc Sci Med. 1999 Jun;48(12):1779-89.
 
The ethical and legal implications of decisions to withhold and withdraw life support have been widely debated. Making end-of-life decisions is never easy, and when the cultural background of doctor and patient differ, communication about these issues may become even more difficult. In this study, we examined the attitudes of people aged 65 and older from different ethnic groups toward foregoing life support. To this end, we conducted a survey of 200 respondents from each of four ethnic groups: European-American, African-American, Korean-American and Mexican-American (800 total), followed by in-depth ethnographic interviews with 80 respondents. European-Americans were the least likely to both accept and want life-support (p<0.001). Mexican-Americans were generally more positive about the use of life-support and were more likely to personally want such treatments (p<0.001). Ethnographic interviews revealed that this was due to their belief that life-support would not be suggested if a case was truly hopeless. Compared to European-Americans, Korean-Americans were very positive regarding life-support (RR = 6.7, p<0.0001); however, they did not want such technology personally (RR = 1.2, p = 0.45). Ethnographic interviews revealed that the decision of life support would be made by their family. Compared to European-Americans, African-Americans felt that it was generally acceptable to withhold or withdraw life-support (RR = 1.6, p = 0.06), but were the most likely to want to be kept alive on life-support (RR = 2.1, p = 0.002). Ethnographic interviews documented a deep distrust towards the health care system and a fear that health care was based on one's ability to pay. We concluded that (a) ethnicity is strongly related to attitudes toward and personal wishes for the use of life support in the event of coma or terminal illness, and (b) this relationship was complex and in some cases, contradictory.
AD
Pacific Center for Health Policy and Ethics and Department of Medicine, University of Southern California School of Medicine, Los Angeles 90033, USA.
PMID