ABSTRACT
This chapter is premised on the view that this society has an insufficient understanding of how and why competent individuals are rendered vulnerable near the end-of-life. Specifically, inadequate attention has been given to the socio-historical and cultural contexts in which individuals function and the import such contexts have for end-of-life decision making. It explores the African-American experience with medicine for the insights that such scrutiny offers for protecting persons from coercion, stigma, and societal indifference. In expanding the images of patients faced with end-of-life decision-making, people enhance their understanding of patients cultural, religious, and family values and the complexity of decision-making with respect to PAS. It concludes that with greater appreciation and knowledge of the realities of African-Americans as well as other patient's lives, it should be possible to modify existing institutional arrangements and practices in the healthcare system in ways that will empower and protect all patients.
