Cultural barriers in oncology: issues in obtaining medical informed consent from Japanese-American elders in Hawaii

In east-west cultural contexts medical decision-making by elderly Japanese-American oncology patients is made complex by cultural differences from mainstream service providers. Cultural, religious and practical factors thought to contribute to delays in obtaining informed consent for treatment in oncology from mentally competent Japanese-American elders in Hawai'i are identified in this study of health care professionals at Queen's Medical Center in Honolulu (n = 50). Circumstances under which Japanese-American elders sign informed consent documents without understanding them are also examined. Recommendations are offered by the participants and researchers for improvements to the informed consent process. Implications of the findings and recommendations are discussed for Health Care Practice with Japanese-American and other ethnic elderly patients in mainstream health care organizations.