Ethical Challenges in Multi-Cultural Patient Care: Cross Cultural Issues at the End of Life

Springer Verlag (2019)
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Abstract

This book provides an up-to-date description of cross-cultural aspects of end-of-life decision-making. The work places this discussion in the context of developments in the United States such as the emphasis on patient informed consent, “right to die” legal cases, and the federal Patient Self-Determination Act. With the globalization of health care and increased immigration from developing to developed countries, health care professionals are experiencing unique challenges in communicating with seriously ill patients and their families about treatment options as well as counselling all patients about advance medical care planning. While many Western countries emphasize individual autonomy and patient-centered decision-making, cultures with a greater collectivist orientation have, historically, often protected patients from negative health information and emphasized family-centered decision-making. In order to place these issues in context, the history of informed consent in medicine is reviewed. Additionally, cross-cultural issues in health care decision-making are analysed from the perspective of multiple philosophical theories including deontology, utilitarianism, virtues, principlism, and communitarian ethics. This book is a valuable addition to courses on end-of-life care, death and dying, cross-cultural health, medical anthropology, and medical ethics and an indispensable guide for healthcare workers dealing with patients coming from various cultural backgrounds.

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Chapters

Conclusion: Continuing Changes in Marriage and Family; Supporting Diverse Perspectives on End-of-Life Decision-Making

As is evident in the case of Mrs. Kim from Chap. 10.1007/978-3-030-23544-4_1, when confronted with serious illness, family relationships are a key element of patient decision-making. While clinicians, including the author, have encountered situations where the family and the patient are at odds with... see more

Why Is There Such Diversity in Preferences for End-of-Life Care? Explanations and Narratives

The differences in views of advance directives, hospice care and do not resuscitate orders that characterize different ethnic and cultural groups may appear illogical to healthcare professionals of White European background.

Advance Directives, Do Not Resuscitate Orders, Hospice, Organ Transplantation and Physician Assisted Suicide

Advance care planning can take a number of forms including discussions with family members that are not formally documented, similar discussions with one’s physician, and directives for level of care during hospitalization such as do not resuscitate orders.

Whether and How to Inform Patients of “Bad News,” Family Dynamics at the End of Life

Telling patients the truth about a life-threatening condition is less common outside of the United States.

A History of Physician “Truth Telling,” Informed Consent, Legal and Religious Perspectives on End-of-Life Care

While patients’ and family preferences for nondisclosure of life-threatening illness found among contemporary Native Americans and Asian Americans may seem to be a cultural anomaly, a brief review of physician practices and legal rulings in the 20th century suggests that disclosure of this informati... see more

Ethical Theories Applied to End-of-Life Medical Care

While medical ethics can be dated back to the Ancient Greeks, cotemporary bioethics’ origin is typically dated to the early 1970s.

History and Background of End-of-Life Decision-Making and Culture

This admonition from members of the Navajo community arose in response to the discussions of terminal illness and a patient’s desire for life-support—both of which are implicit topics in discussions of advance directives.

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