Monthly Archives: January 2011

User Consultation: Patients and Carers

The ‘Cultural Issues in End of Life Care Team’ are interested to hear patients, carers and health care professionals’ opinions and experiences of end of life care.

In order to better focus our work, we would like people to share with us their opinions and experiences, particularly the impact of culture and cultural differences in different countries and places of care.

We would also appreciate any general comments about the blog, the work and features posted to the blog, or the focus of our work.

The research carried out by our team has identified a number of important priorities in regard to culture and end of life care. We would be particularly interested to know what patients, carers and health care professionals think about the following two issues:

1. Cultural competence and care for minority ethnic groups

Evidence of low use of end of life care services by minority ethnic groups and some dissatisfaction with care has increased the popularity of ‘cultural competency’ approaches.

‘Cultural competency’ training attempts to make health care professionals sensitive to cultural differences, provide them with knowledge about different cultural traditions and includes specific skills training in areas such as communication.1-3

There have, however, been a number of criticisms raised about such training – that a focus on information about specific cultural groups can lead to stereotyping and that such training serves to routinise the encounter between healthcare professionals and service users from different cultural backgrounds.4 5

What do you think about such training?

Do you think such training can improve the quality of care?

Do you think it will lead to people from minority ethnic groups being treated differently?

Are you a healthcare professional who has undertaken such training? Do you feel that cultural competency training improved your interactions with people from different cultural backgrounds? If not, why not?

Please share your opinions and experiences by posting a comment!

2. Diversity in changing environments

Cultural differences can be as pronounced between people from different generations as people from different cultural backgrounds. In the context of changing cultural identities how should cultural preferences be taken into account in end of life care?

Do you think that cultural competency approaches are useful or even appropriate in a changing society?

Post a comment and let us know what you think!

1. Papadopoulos I, Tilki M, Taylor G. Transcultural care: a guide for health care professionals. 1998.

2. Lister P. A Taxonomy for Developing Cultural Competence. Nurse Education Today 1999;19(4):313-18.

3. Campinha-Bacote J. The process of cultural competence in the delivery of health care services: A model of care. Journal of Transcultural Nursing 2002;13(3):181-84.

4. Gunaratnam Y. Intercultural palliative care: do we need cultural competence? International Journal of Palliative Nursing 2007;13(10):470.

5. Gunaratnam Y. From competence to vulnerability: Care, ethics, and elders from racialized minorities. Mortality 2008;13(1):24-41.

Book Review: The Maintenance of Life: Preventing Social Death through Euthanasia Talk and End-of-Life Care – Lessons from the Netherlands

Frances Norwood’s book ‘The Maintenance of Life: Preventing Social Death through Euthanasia Talk and End- of-Life Care – Lessons from the Netherlands’ provides an in-depth look into end-of-life care in the Netherlands and how legal euthanasia has helped to shape this landscape.

The book draws on 15 months of qualitative data including direct observation and in-depth interviews with general practitioners, end-of-life patients and their family members.

Norwood argues that conversations concerning euthanasia rarely culminate in a euthanasia death. Furthermore, these discussions open up a more general discussion about end-of-life between patients, their families and healthcare professionals. They can provide a space for patients to talk about their suffering, reaffirming social bonds and self-identity, helping to prevent “social death.”

Norwood examines how the euthanasia policy in the Netherlands has shaped the experience of patients at the end-of-life and how this compares with the situation in the United States.

Reviewer – Erin VW Andrew