The Role of the Family in End-of-Life Decision-Making across Cultures: Nuances Not Rules

[Speaker] Searight, Russell:1
1:Lake Superior State Univerrsity (United States of America)

Preferences for end-of-life decision-making appear to be partially influenced by culture. Early U.S. research suggested that persons from Asian and Latin American backgrounds were more likely than White Northern Europeans to indicate that information about serious illness should be shared with the patient's family, rather than the patient, themselves. Similarly, this same familial-individual cultural pattern has been found to influence treatment decisions. Qualitative studies, including research with Bosnian immigrants, suggest several reasons for withholding diagnostic and treatment information including protecting the patient from emotional harm and maintaining hope. Chinese bioethicists describe individual autonomy, as reflected in U.S. medical ethics and law, as an artificial excision of the patient from their meaningful relationships and alternatively, emphasizes shared decision-making with the physician joining the patient's family. A recent systematic review and qualitative observations indicated that, within and outside the U.S., these cultural differences may be becoming less pronounced.
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