title: When race matters.
abstract: Several widely held assumptions shape end-of-life discussion in the United States. They are embedded in mainstream bioethics and biomedical discourse, debate, and discussion, as well as in the popular media. We have come to regard them as the conventional wisdom. Despite their apparent reasonableness, the assumptions are not held universally by all US citizens, particularly those of color. They hold contradictions that partially explain why fewer African Americans than whites complete advance directives, and why African Americans tend to desire aggressive care at the end of life. This article considers some of these assumptions. It then considers a case and an approach to care that seeks to resolve potential conflicts proactively.
authors.affiliation: Center for Bioethics and Health Law, University of Pittsburgh, 5923 Kentucky Avenue, Pittsburgh, PA 15232, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Dula
authors.forename: September
authors.initials: S
authors.lastname: Williams
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D018447:Medical Futility; D010147:Pain Measurement; D010166:Palliative Care; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D011788:Quality of Life; D017236:Suicide, Assisted; D013727:Terminal Care; D014481:United States