title: A discourse of relationships in bioethics: patient autonomy and end-of-life decision making among elderly Korean Americans.
abstract: A two-year, multidisciplinary study (N = 800) was conducted on attitudes about end-of-life decision making among elderly individuals in four ethnic groups (African American, European American, Korean American, and Mexican American). On a quantitative survey, Korean Americans reported negative attitudes about the use of life-sustaining technology for themselves but positive attitudes about its use in general. This article reports on an interview with a 79-year-old typical Korean American respondent to explain the contradiction in the survey data. Expectations among elderly Korean Americans include protecting family members with a life-threatening illness from being informed of their diagnosis and prognosis, and doing everything to keep them alive. Two conclusions, one substantive and the other methodological, are drawn: First, the bioethics discourse on individual rights (patient autonomy) is insufficient to explain the preferences of many Korean Americans and must be supplemented with a discourse on relationships. Second, the rigorous use of qualitative, narrative methods clarifies quantitative data and should not be dismissed as "anecdotal."
authors.affiliation: Department of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles 90033, USA.
authors.forename: G
authors.initials: G
authors.lastname: Frank
authors.forename: L J
authors.initials: LJ
authors.lastname: Blackhall
authors.forename: V
authors.initials: V
authors.lastname: Michel
authors.forename: S T
authors.initials: ST
authors.lastname: Murphy
authors.forename: S P
authors.initials: SP
authors.lastname: Azen
authors.forename: K
authors.initials: K
authors.lastname: Park
mesh_terms: D016223:Advance Directives / Q000208:ethnology*; D000368:Aged; D001213:Asian / Q000523:psychology*; D001293:Attitude to Death / Q000208:ethnology*; D001675:Bioethics; D018864:Cultural Diversity; D005190:Family; D005260:Female; D006801:Humans; D007723:Korea / Q000208:ethnology; D010344:Patient Advocacy; D010358:Patient Participation; D014342:Truth Disclosure