Cultural beliefs on death

Dr Megan-Jane Johnstone, from the School of Health at Deakin University, believes health professionals should ask patients about their end-of-life beliefs.

“If medical and allied health staff are uncertain as to what specific cultural differences might apply to a patient in end of life, they should start by asking the patient… and talking to their family,” Dr Johnstone says.

She claims cultural considerations associated with end-of-life care remain “poorly understood, poorly guided, and poorly resourced” in health care.

Dr Johnstone’s views appear in the Journal of Medical Philosophy in the article ‘Bioethics, Cultural Differences and the Problem of Moral Disagreements in End-Of-Life Care: A Terror Management Theory’.

“Although there has been a strong emphasis in recent years on making policy commitments to patient-centred care and respecting patient choices, persons whose minority cultural worldviews do not fit with the worldviews supported by the conventional principles of western bioethics face a perpetual struggle in getting their care needs met in a meaningful, safe, and healing way,” she wrote.

For people whose cultural worldviews are not consistent with the western world, Dr Johnstone claims the underpinning values of advance care planning and euthanasia intensify rather than ease their deathrelated anxieties.

“Contrary to the views of the cultural majority, the idea of autonomy is isolating and disempowering; informed consent a violation of the protective role and collective decision-making authority of the family,” she says.