The book, ‘cultural issues in end-of-life decision making,’ provide a better way of dealing with end-of-life decision making since it is one of the most difficult tests that patients and their families have to go through. Since there is inadequacy of helpful resources to assist clinicians to offer guidance in these decisions, this book is a helpful tool in equipping them to fulfill this role. Clinicians are most of the time in direct contact with the patients, their relatives and friends at the time of making crucial decisions. This book, though written from an American perspective, has elaborate depictions of particular cultural influences on end-of-life decision making, which makes it to be eligible for wide readership. It does a commendable work of giving the issues and a broad overview of cultural and religious issues faced by the medical experts.
The book addresses the physical, legal, and ethical dimensions of dying (Braun et al). An Act that became effective in 1991 obliges all American hospitals to make available to patients all the information about their rights in terms of making decisions. Hospital clerks are therefore compelled to decide whether the patient has an advance directive. One of the clinical ethical considerations argues that the inclusion of a ‘values history’ as a component of the advance directive might ease decision making when the anticipated critical illness occurs. The authors give a description of research findings on the complexities brought by ‘values of history.’
The book outlines that three common reasons that medical cases ends up in the courtroom are conflicts amongst surrogates and providers, anxiety held by providers of their legal liability and insufficient communication between the parties involved. The authors lay emphasis that clinicians ought to develop, adopt, and apply both substantive policies and operational procedures when faced with ethical dilemmas on handling issues related to critically ill patients.
The book elaborates on the history, hierarchy and practices of various religious groups in dealing with end-of-life decision making and death. The book outlines the attitudes to advance directives, withholding and withdrawing life-prolonging treatments, physician-assisted suicide, organ donation and autopsy. The authors do a creditable job of striking the right balance between the whole belief system of a particular religion and the rebellious perceptions within the specific belief system. All the religions discussed in the book agree on the necessity of making consultations with family members. Some emphasize that the family consultation is superior to the patient’s own independent right to medical information.
The book addresses the issues concerning Institutional cultures (Hospital and Nursing Home and the Military) and ‘special populations’ (HIV/AIDS) and those who have been diagnosed with long-term ailments. In relation to technology driven medicine, passing from life to death is viewed as a disappointment and some aspects of the medical fraternity (especially A&E and ITE) are not sufficiently prepared to handle decisions at the time of critical illness. The debate on physician-assisted suicide relating to patients with terminal illnesses is talked about in detail. The authors disapprove, with excellent scenarios of good quality life, the view that some people have that patients with disability and chronic illness are having terminal conditions.
As a whole, the authors succeed in presenting diverse attitudes, customs, and passions coming from ethnic, religious, and institutional backgrounds. I would recommend the book as a helpful manual to health and social services workers dealing with crucial cultural end-of-life issues.
Work cited
Braun, Kathryn et al. Cultural issues in end-of-life decision making. California: Sage Publications, 2000. Print.