ABSTRACT
In this chapter, we discuss cultural, racial, ethnic, and individual differences in end-of-life decision making. Such variation is important to recognize in that it helps us understand (a) why persons from various backgrounds feel and behave the way they do regarding end-of-life choices and (b) which barriers interfere with the making of such choices. At the same time, this very sensitivity should alert us to the fact that many of the assumptions we make about persons whose life experiences and cultural heritages are different from our own often are inaccurate. We end up walking a fine line between appreciating the unique perspective that people may have (e.g., how their race or ethnicity differentiates them from others); relying on overgeneralizations about them to the exclusion of other influences on their views, feelings, and behaviors related to end-of-life issues; and appreciating individual differences among persons, taking into consideration not only race, ethnicity, and culture but also age, gender, sexual orientation, socioeconomic status, religion/spirituality, and health/disability status. Consequently, our discussion will interface with chapters dealing with caregiving, hospice care, the influence of religion and spirituality, legal considerations, and competence.
