Study: Races Have Different Wishes for Twilight Years
A recent study by a University of Michigan faculty member suggests that racial and ethnic cultural differences extend even to the final days of life. Dr. Sonia A. Duffy, a research investigator in UM’s departments of otolaryngology and psychiatry, served as lead author of a study titled “Ethnogeriatrics and Special Populations” which examined the responses of 73 focus group members.
The study found that members of different racial and ethnic groups often approach end-of-life care from very different perspectives. For example, all of the Arab participants, whether Muslim or Christian, indicated that the family is responsible for the care of a dying member. In many cases, the entire neighborhood shoulders the responsibility. But African-Americans, and particularly Black men, did not place as much emphasis on the role of the family. And while White respondents also didn’t feel it was the responsibility of the family to take care of them, they generally preferred to die at home rather than a hospital or retirement community.
“One of the most important findings in our study is that there are so many different points of view, it is important for health care providers to treat everyone as an individual,” says Duffy.
The study, which focused on Arabs, Blacks, Hispanics and Whites over the age of 50 found that the Hispanic respondents were most concerned about dying with dignity. Hispanic men were more likely to view assisted suicide as an option, although some said they preferred the name “assisted dying.”
“I don’t think it is suicide if you’ve already been predetermined and everyone knows that you’re going to die,” said one Hispanic man in the study.
Hispanics were also more likely to try alternative medicines and wanted to control their place of death. Like Hispanics, the Arabs studied were strongly against nursing homes, preferring to remain in their homes under the care of family members. Arabs were also “significantly more concerned with their accomplishments in life and preferred to have their finances in order before dying,” the study said.
Blacks and Whites, meanwhile, were much more receptive to the idea of nursing home or hospice care. Black respondents actually preferred intensive care units or nursing homes to living at home, saying they didn’t want to burden their families. But although the subject wasn’t asked directly, many of the Black men indicated a distrust of doctors, influenced in large part by the Tuskegee experiment and other incidents of medical injustice. White respondents were the most likely to want to know what to expect about pain and other effects of their conditions. And they were generally opposed to extensive life-saving techniques, mirroring the opinions of Arabs and Hispanic men. Interestingly, the African-American and Hispanic women surveyed indicated a much stronger willingness to undergo extensive intervention
“We should keep in mind that our country’s medical system is based on Western values, and that those values may not translate to other cultures,” Duffy says. “Deeply rooted cultural beliefs and values are difficult to influence.”
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