Multi-cultural and multi-ethnic considerations and advanced directives: developing cultural competency

Area of Science:

• Nursing
• Medical Ethics
• Cultural Studies

Background:

• The Patient Self-Determination Act (PSDA) of 1991 established end-of-life care values in the US.
• These values include patient autonomy, informed consent, truth-telling, and control over the dying process.
• These PSDA values may conflict with the beliefs of minority cultures in the US.

Purpose of the Study:

• To examine the potential conflicts between the PSDA's values and diverse cultural beliefs regarding end-of-life care.
• To highlight the importance of culturally competent care in nursing practice.
• To provide a framework for assessing cultural needs at the end of life.

Main Methods:

• Literature review examining the PSDA and cultural end-of-life beliefs.
• Application of the Giger and Davdihizar Transcultural Assessment Model.
• Analysis of potential value conflicts in culturally competent care delivery.

Main Results:

• The PSDA's assumptions regarding autonomy and control may not align with all cultural perspectives.
• Nurses face challenges in delivering care that respects both legal mandates and cultural practices.
• Cultural assessment is vital for identifying and navigating these conflicts.

Conclusions:

• Culturally competent nursing care requires acknowledging and integrating diverse end-of-life beliefs and rituals.
• The Giger and Davdihizar Transcultural Assessment Model aids in planning patient-centered, culturally sensitive end-of-life care.
• Respecting cultural nuances is essential for ethical and effective end-of-life care.