What Influences African American End-of-life Preferences?

The U.S. population is aging and increasingly culturally diverse. The challenges of an aging population desiring a good end to their lives combined with soaring costs for medical care serve as a mandate for providers to be aware of both patient preferences and other factors influencing decision-maki...

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Bibliographic Details
Published in:Journal of health care for the poor and underserved 2012-02, Vol.23 (1), p.28-58
Main Authors: Wicher, Camille P, Meeker, Mary Ann
Format: Article
Language:English
Subjects:
African Americans
African Americans - psychology
Ageing
Aging
Black American people
Cultural differences
Decision making
End of life decisions
Ethnicity
Health care
Hispanic people
Humans
Minority & ethnic groups
Palliative care
Patient Preference - ethnology
Preferences
Randomized Controlled Trials as Topic
Religion
Systematic review
Terminal Care - psychology
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Summary:The U.S. population is aging and increasingly culturally diverse. The challenges of an aging population desiring a good end to their lives combined with soaring costs for medical care serve as a mandate for providers to be aware of both patient preferences and other factors influencing decision-making at the end of life. Systematic review of published research studies examining African American preferences related to end-of-life care and decision-making. There are well documented differences in preferences for end-of-life care and utilization of services between non-Hispanic Whites and African Americans. African Americans do not use advance care planning (ACP) documents or hospice to the same extent as non-Hispanic Whites, and, even after controlling for income and access, the difference is significant. Many African Americans choose aggressive life-sustaining treatment at the end of life, even if that treatment seems likely to confer great burden with little chance of benefit. The reasons for this are multi-faceted and include knowledge of and access to services, historical mistrust of the health care system, and spiritual beliefs. African American end-of-life choices are influenced by knowledge of and access to services as well as by shared cultural beliefs in the role of family and others in decision-making, mistrust toward the health care system, and the importance of spirituality.
ISSN:1049-2089
1548-6869
1548-6869
DOI:10.1353/hpu.2012.0027