End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age.Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis.Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles.Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.
Yoruba conception of “eniyan l’aso mi” meaning “humans are my clothing” represents the deep cultural belief in the importance of having reliable people for support whenever needed. Social production of care is production and distribution of roles and responsibilities in caregiving. Individual household members care for their relatives differently. While this concept of eniyan l’aso mi influences social relationship generally in the Yoruba society it is not clear how this will translate to social production of care for the elderly. Considering the changes in social realities of the elderlies and their families, this study, examined, family care provision for the elderlies living with chronic conditions. Using Symbolic Interactionism and Role Theory for the theoretical analysis, data were generated on familial support for elderly living with diabetes mellitus/cardiovascular diseases. Twenty-four In-Depth Interviews and Twelve Key Informant Interviews were conducted among elderlies and their caregivers selected from the community and Old People’s Home. The generated data was content-analyzed in line with the thematic of the study. Change in residential pattern, rising cost of living, children’s late entrance into marital/family life and disintegration of familial bond were observed factors influencing familial care of the elderly. Furthermore, children were found to be the most reliable source of family support for these elderly; familial support was not only found to be preferred to other sources of support, it was also found to be positively associated with aged quality of life. Although familial support is a key determinant of chronically ill elderlies’ quality of life, measures guaranteeing elderly access to care must be put in place.
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