title: Chinese seniors' perspectives on end-of-life decisions.
abstract: Making end-of-life decisions is a painful and difficult process; one that can be intensified by cultural differences between physicians and their patients. The objective of this study was to examine attitudes of Chinese seniors towards end-of-life decisions. We conducted a qualitative survey in a Chinese community centre in Toronto, Canada. Face-to-face interviews, in Cantonese, were conducted with 40 Chinese seniors 65 years of age or older. Respondents based their end-of-life decision making on the following factors: hope, suffering and burden, the future, emotional harmony, the life cycle, respect for doctors, and the family. Respondents rejected advance directives. Respondents' attitudes toward end-of-life decision making can be understood through the lens of values from Confucianist, Buddhist and Taoist traditions. Health care workers can best achieve quality end-of-life care--and address the cultural differences that may arise--by focusing primarily on understanding the perspectives of patients and their families, and by continually striving for balanced and open communication at all stages of the caregiving process.
authors.affiliation: Mount Sinai Hospital, Toronto, Ont., Canada.
authors.forename: K W
authors.initials: KW
authors.lastname: Bowman
authors.forename: P A
authors.initials: PA
authors.lastname: Singer
mesh_terms: D016223:Advance Directives; D000368:Aged; D001293:Attitude to Death / Q000208:ethnology*; D002681:China / Q000208:ethnology; D003469:Culture; D003657:Decision Making; D006801:Humans; D009864:Ontario; D013727:Terminal Care