Ethical Challenges in Multi-Cultural Patient Care

Book excerpt: This book provides an up-to-date description of cross-cultural aspects of end-of-life decision-making. The work places this discussion in the context of developments in the United States such as the emphasis on patient informed consent, “right to die” legal cases, and the federal Patient Self-Determination Act. With the globalization of health care and increased immigration from developing to developed countries, health care professionals are experiencing unique challenges in communicating with seriously ill patients and their families about treatment options as well as counselling all patients about advance medical care planning. While many Western countries emphasize individual autonomy and patient-centered decision-making, cultures with a greater collectivist orientation have, historically, often protected patients from negative health information and emphasized family-centered decision-making. In order to place these issues in context, the history of informed consent in medicine is reviewed. Additionally, cross-cultural issues in health care decision-making are analysed from the perspective of multiple philosophical theories including deontology, utilitarianism, virtues, principlism, and communitarian ethics. This book is a valuable addition to courses on end-of-life care, death and dying, cross-cultural health, medical anthropology, and medical ethics and an indispensable guide for healthcare workers dealing with patients coming from various cultural backgrounds.