title: End-of-life treatment decision making: American Indians' perspective.
abstract: This study explored American Indians' end-of-life experiences in treatment decision making. Scarce knowledge about this population's perspective regarding end-of-life treatments has resulted in health care providers (HCPs) functioning at less than optimum levels. Using a community-based participatory research approach, open-ended interview data were collected and analyzed using a grounded theory method. Patient and family participants generally stated that the physicians made the treatment decisions for them, while HCPs believed that patients participated in informed autonomous treatment decision making. Both parties (HCPs and patients and families) were not aware of American Indian's psychological aspect that interfered with the exercise of the right of informed consent. This additional understanding would benefit them in order to result in ethically and legally sound practice of patient's autonomous treatment decision making.
authors.affiliation: College of Nursing, Montana State University, Bozeman, MT, USA yoshikoc@montana.edu.
authors.forename: Yoshiko Yamashita
authors.initials: YY
authors.lastname: Colclough
authors.affiliation: College of Nursing, Montana State University, Bozeman, MT, USA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055812:Community-Based Participatory Research; D003657:Decision Making; D005190:Family / Q000208:ethnology*; D005260:Female; D006801:Humans; D007198:Indians, North American; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D010817:Physician-Patient Relations; D012067:Religion; D013727:Terminal Care / Q000458:organization & administration*
keywords: American Indian; community-based participatory research; decision making; end of life; ethical; legal; patient and family; qualitative