ISSN Print: 2151-805X
ISSN Online: 2151-8068
Made-to-Measure Palliative Care: An Ethical Imperative for Growing Cultural Plurality in the United States
ABSTRACT
Delivering culturally attuned palliative care, or noncurative support for the dying and those in need of serious symptom management, that is, "made-to-measure", is an ethical imperative, if that care is to be just. Differences in culture play a role in the way that people perceive the death and dying process. Standardized approaches to healthcare are not always congruent with a patient's cultural identification, and this can result in suboptimal care delivery that can affect patient outcomes as well as patients' and families' satisfaction with care. U.S. Census data indicate further rapid growth of racial and ethnic diversity, especially among those of Hispanic and Asian origins. In this review, six tiers of influence are identified and discussed as areas where change must occur to achieve system-wide improvements in the delivery of culturally attuned palliative care that is just. Affecting change on each of the identified tiers may achieve the most concrete changes toward improving culturally appropriate, made-to-measure, end-of-life, and palliative approaches to care. When clinicians and healthcare systems know more about the people whom they serve, they can provide the correct amount of care−impacting savings, expenditures, and health outcomes−and the correct approach to care that incorporates cultural values and is more ethically sound.
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