Cultural concerns in end of life care term paper

End Of Life, Palliative Care, Lifestyle Support, Bioethics


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Ethnic Issues in End of Life Care

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In this associated with increased social diversity the cultural aspects of end-of-life proper care have become progressively important in the nursing occupation. This importance is however complicated by technology as well as the cultural problematics of endurance care through artificial means. In the book Social Issues in End-of-Life Decision Making (Braun, E, Pietsch, J. H. Blanchette, P. 1999) the crucial point is made that “providing cultural and spiritually sensitive care requires that nurses, medical doctors, social workers and others know and understand the implications of family members’ beliefs about life and death, supportive rituals and also other activities. inch (Review: cultural Issues in End-of-Life Decision Making, 2004)

This guide underlines the fact that social issues in end-of-life proper care have important implications to get nursing – especially in that professional healthcare professionals should have know-how or always be cognizant with the wider social and sociable context or milieu in which they operate. This also implies the introduction of a particular tenderness to the typically complex culture context of end-of-life patients. “Culture shapes one’s taboos about fatality and preferences with regard to airport terminal illness. inch (ibid) The study stresses that issues just like life support and other moral areas depend largely within the cultural context of the patient.

Another research also emphasizes this point. “Advanced modern societies are characterized by cultural selection and it is occasionally difficult pertaining to health professionals to know how to provide appropriate and culturally sensitive end-of-life attention to people in multi-ethnic communities. ” (Field, David, 2004) This kind of study in multi-ethnic adjustments in Canada as well as the U. S. A. observes that

… the majority of contemporary materials in bioethics stresses the importance of fact telling, the principles of autonomy and affected person choice and the value of advanced attention planning. Yet , these principles run table to morals and values of many ethnic groups in these societies. (ibid)

These are elements that the medical staff has to be aware of in order to provide the most effective qualitative assistance to the patient.

End-of lifestyle care nursing jobs requirements are in themselves complex and an area in which more research is required. The research in palliative proper care has during the last decade focused on a holistic method of the issue. This refers to treatment strategies that include the larger context from the patient’s your life; such as cultural, psychological and spiritual needs. More recently research in these areas have been expanded to include a level wider range of contextual issues and the focus on the sensitive mechanics that tradition plays with this form of breastfeeding care.

‘Since 2000, papers on this topic have taken a wider look at, looking at end-of-life care for seniors, technology and death policy, bioethics, plus the use of do-not-resuscitate orders. ” (Field, David 2004) These kinds of comments label a central issue that impacts upon cultural factors in the proper care of these individuals; namely, advancements in modern technology.

Technology today allows sufferers to live for a longer time in manufactured conditions which could create difficulties with regard to cultural norms and values. In a research entitled Cultural influences on end-of-life decision-making by Frances C. Knutson, Stephanie Schim, and Sonia Duffy, the author’s point out:

The growth of sophisticated life-sustaining medical technology has resulted in greater awareness of medical care on the end-of-life (EOL). These issues are very relevant to get a growing number of adults in america and their members of the family who happen to be faced with significantly complex options related to initiating, withholding, and terminating medical treatment.

(Frances C. Jackson, Stephanie Schim, and Sonia Duffy)

The experts continue to claim that within the contemporary hospital environment, culture is now an extremely significant factor in bettering palliative treatment. They also point out that disparities in cultural backgrounds among patient and health care personnel may become a problematic place unless even more attention is usually paid to cultural facets of end-of-life treatment.

Many of these people and family members will be people of color, as it is expected that by third decade of the twenty-first century, persons of color will out number European-Americans 51% to 49% (Fitzgerald, 1992). These individuals are getting advice in EOL decisions from a workforce that may be largely composed of European-Americans. How this advice is given and received will be generally influenced by the culture with the recipient of treatment, the traditions of the provider of attention, and the traditions of the institution where the proper care is being received.


The authors as well state that an awareness of ethnic needs and requirements within the hospital situation is a means of reducing virtually any potential issue areas. (ibid) The study is definitely informative and opens up regions of concern pertaining to professional healthcare professionals working in this place. For example

A single major area addressed was to ascertain beneath what circumstances African-Americans will utilize hospice services. Some participants indicated they would be reluctant to use hospice companies because this means giving up desire. Statements such as, “Black persons don’t believe in giving up” and “I would not want to give up treatment, but the relax sounds nice” are absolutely culturally motivated.


An additional example of just how that ethnical insight can easily impact on the understanding of the cultural complexity that underlies end-of-life proper care is the subsequent:

Several concentrate group members stated that they would not be able to sleep in the bed wherever their family member had died. If without a doubt this is an issue for African-Americans, then this ethnic group may not view death in the home as preferable to dying within an institution. (ibid)

A further showing example in the study reveals the significance of cultural understanding during these situations.

Dark people use so much energy trying to live; they can’t take time worrying about declining. Overall, several individuals inside the group indicated the thought that Black persons don’t plan for death. “We don’t do wills, pre-pay for each of our funerals, produce plans to die. inch If talking about the subject of fatality is an avoided concern for African-Americans, this has great implications to get physicians and also other health care providers up against the task of discussing termination of lifestyle support and withholding extraordinary measures to sustain existence with groups of terminally unwell patients. (ibid)

This study and others concentrates attention for the important aspect of communication. This is certainly a crucial place for medical staff and one which needs further research. In the study by the SE TILL ATT DU ÄR Glahs Medical Research Council on Tradition and Racial, areas of matter are labeled with regard to connection with individuals of different ethnic groups.

Medical jargon can be confusing, ambiguous, or misinterpreted (Tulsky, Fischer, Rose, Arnold, 1998). Medical doctors typically discuss too in short , about end-of-life options and might not know to demonstrate admiration for a person’s culture or perhaps values. Translations and culturally sensitive crafted information in native ‘languages’ are lacking (Hern et ing., 1998). Speaking another terminology or having limited British skills complicates discussions or asking for help (Phipps, The case Pomerantz, 2000).

(Research You should use To Improve Care)

There are an increasing number of studies, information and books that are evolving new ways to enhance assistance to end-of-life patients via a ethnic perspective. One of these is Cultural variations in dying, fatality and suffering: Diversity in universality (Irish, D. S., Lundquist, K. F., Nelsen, V. T. 1993)

Another area which includes implications intended for the nursing profession and which is still a new invention in terms of exploration, is the understanding of spiritual and religious problems in end-of-life care. This obviously contains a strong cultural component. The mixing of an understanding of cultural spiritual and psychic aspects has proved to be important for nursing staff in dealing with these patients, while the study simply by David Discipline found; “… The nurses… interviewed acquired ‘integrated their very own spirituality’ to their nursing function and that the spiritual dimension ‘infiltrated all dimensions of (their) nursing care’. (Field, David, 2004) In this regard an important examine is Richard Golsworthy and Adrian Coyle’s discussion regarding spiritual opinion and the seek out meaning when confronted with death. (GOLSWORTHY, R. COYLE, A. (1999)

Recommendations for even more research are produced in almost every serious study with this subject. The following extract challenges that more aimed and particular research in localized aspects of cultural input into the end-of-life situation must be addressed.

… we must develop a exploration agenda that will address just how end-of-life decision-making is formed within a particular cultural circumstance. This analysis will need to be carefully crafted to avoid the issues of simplistic and deterministic use of racial, ethnic, or cultural classes. The research must be constructed with a great eye toward the intricacy of power dynamics in the social establishing of hospital, clinic, or perhaps nursing residence.

(Integrative Workshop on End-of-Life Research)

To summarize, the effects of ethnical understanding in end-of-life treatment have critical research and learning effects for the nursing profession. In this complicated and delicate circumstance the specialist nurse has to be aware of the ramifications in the cultural rules and rituals that apply to the individual and his or perhaps her relatives. It is only via an awareness of the total context the nurse can provide adequate care and assistance. The

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