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Ethnicity and attitudes toward patient autonomy
L J Blackhall1, S T Murphy, G Frank
1Department of Medicine, Pacific Center for Health Policy and Ethics, University of Southern California, Los Angeles, USA.
JAMA
|September 13, 1995
Summary
Ethnic differences in end-of-life care preferences were observed. Korean Americans and Mexican Americans favored family-centered decision-making, unlike European and African Americans who preferred patient autonomy.
Area of Science:
- Gerontology
- Sociology
- Medical Ethics
Background:
- Cultural attitudes significantly influence end-of-life (EOL) care preferences.
- Understanding ethnic variations in EOL decision-making is crucial for culturally sensitive medical practice.
Purpose of the Study:
- To investigate ethnic group differences in attitudes towards disclosure of terminal illness diagnosis and prognosis.
- To examine variations in EOL decision-making preferences among diverse elderly populations.
Main Methods:
- A survey research design was employed.
- Data collected from 800 elderly subjects (aged 65+) across four ethnic groups: European American, African American, Korean American, and Mexican American.
- Participants recruited from senior citizen centers in Los Angeles County.
Main Results:
- Significant ethnic disparities found in attitudes toward disclosure of cancer diagnosis and terminal prognosis.
- Korean Americans and Mexican Americans were less likely to believe patients should be informed of diagnosis/prognosis compared to European and African Americans.
- Korean Americans and Mexican Americans preferred family-centered decision-making for life support, contrasting with the patient autonomy preference of European and African Americans. Ethnicity emerged as the primary predictor.
Conclusions:
- Elderly Korean Americans and Mexican Americans predominantly favor a family-centered model of medical decision-making.
- European American and African American elderly subjects largely preferred a patient autonomy model.
- Physicians should inquire about patient preferences regarding information disclosure and decision-making involvement, or if family involvement is desired.