The Legal And Ethical Effects Of Decision Making - 2828 Words

Chapter 4: Discussion Results Introduction The legal and ethical effects of decision making in withholding and withdrawing life support have been largely debated. The unanimity in the United States is that it is standard to waive or decline life support with permission of the patient or a surrogate under some circumstances (American Thoracic Society, 1991; Council on Ethical and Judicial Affairs, 1991). However, such practice is not always accepted and varies greatly from country to country and over time (Asplund and Britton, 1990; Koch et al., 1994). End of life decision making can be a very stressful event for both the physician and the patient; and when there are two conflicting cultural backgrounds, communication about these†¦show more content†¦Most of these individuals view advance directives as a legal intrusion that interferes with the family’s rights and responsibilities to care for a loved one. They also think that warm health care decisions at the end stage of one’s life should be a matter between the family and patient’s physician, not the state or the healthcare system (Bito et al., 2007). Individuals of minority cultural backgrounds are afraid that if they complete an advance care planning in a typical health care setting, it might be detrimental to them in cases where further medical intervention could actually improve their health outcome (Baker, 2002). Data have shown that there’s a low level of trust in the healthcare system within the many minority groups, and even a lesser of trust within the Black group, especially if in the past they have been mistreated and discriminated against (Baker, 2002). Research has also indicated that Blacks from different cultural backgrounds prefer life-prolonging, aggressive treatment to be administered regardless of the condition of their disease, even when it seems hopeless (Baker, 2002). West and Levi (2004) f ound that the historic disbelief of the healthcare system and lack of accessibility of care mirrors the views of African-Americans of end-of-life care. The removal of mechanical support, withdrawal of life-prolonging