Native American Death Taboo: Implications for Health Care Providers

Colclough, Yoshiko

doi:10.1177/1049909116638839

Cited by 15 publications

(8 citation statements)

References 26 publications

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“…For example, studies in North America show that some Native American cultures have taboos against talking about death, which can make enrollment in end-of-life palliative care difficult. 56 While making assumptions about level of information to share may lead to stereotyping and erasure of individual variations within these groups, clinicians can attend to these differences in communication by gently inquiring about how much one already knows and how much they desire to know about their condition. 57 Within-group variations are also salient.…”

Section: Communication Patternsmentioning

confidence: 99%

Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making

Cain

Surbone

Elk

et al. 2018

Journal of Pain and Symptom Management

185

150

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Palliative care is gaining acceptance across the world. However, even when palliative care resources exist, both the delivery and distribution of services too often are neither equitably nor acceptably provided to diverse population groups. The goal of this study was to illustrate tensions in the delivery of palliative care for diverse patient populations to help clinicians to improve care for all. We begin by defining and differentiating culture, race, and ethnicity, so that these terms-often used interchangeably-are not conflated and are more effectively used in caring for diverse populations. We then present examples from an integrative literature review of recent research on culture and palliative care to illustrate both how and why varied responses to pain and suffering occur in different patterns, focusing on four areas of palliative care: the formation of care preferences, communication patterns, different meanings of suffering, and decision-making processes about care. For each area, we provide international and multiethnic examples of variations that emphasize the need for personalization of care and the avoidance of stereotyping beliefs and practices without considering individual circumstances and life histories. We conclude with recommendations for improving palliative care research and practice with cultural perspectives, emphasizing the need to work in partnerships with patients, their family members, and communities to identify and negotiate culturally meaningful care, promote quality of life, and ensure the highest quality palliative care for all, both domestically and internationally.

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Section: Communication Patternsmentioning

confidence: 99%

Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making

Cain

Surbone

Elk

et al. 2018

Journal of Pain and Symptom Management

185

150

View full text Add to dashboard Cite

show abstract

“…A Team member agreed with the finding as well and denied a theoretical reason of taboo on death as the Creator's realm. 16 Loss is so painful that denial and aversion to death consumes the mind, which validates a taboo perception of end-of-life discussion. Another interviewee offered an explanation similar to the historical indigenous perception that a transition period of death needs to be supported without any disturbance for the spirit to cross over the spiritual realm.…”

Section: Interviewmentioning

confidence: 92%

“…A death taboo perception exists everywhere in the world as well as among indigenous people. 16,17 A recent theoretical review finds 3 potential explanations about death taboo perception by the AIs. 16 They are: (1) a human should not invade the Creator's realm of decision/control on a time of passing; (2) silence would reduce the harm by an evil aspect of the deceased spirit; and (3) a talk of death may trigger another death due to the power of words and bad luck.…”

Section: Historical Indigenous Perception On Death and Dyingmentioning

confidence: 99%

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Moving Toward Openness: Blackfeet Indians’ Perception Changes Regarding Talking About End of Life

Colclough

Brown²

2018

Am J Hosp Palliat Care

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This study was conducted to examine cultural appropriateness and readiness for the Blackfeet people in the United States talking about end of life. In the past, a taboo perception of Blackfeet traditional belief in end-of-life discussion was identified as a core barrier for hospice use. However, a recent anecdotal increase in hospice interest triggered the research team to investigate community-wide interest as well as traditional appropriateness of hospice introduction. The community-based participatory research approach was used to conduct the study. Using convenience sampling, we interviewed 10 tribally recognized Elders and surveyed 102 tribal members who were over 18 years old using a modified Duke End-of-Life Care Survey. Here, our report focused on the perception changes on end-of-life discussion. The elders' statements were divided into two, saying that an end-oflife discussion was not against tradition and that sickness and death would break the living spirit, thus no such discussion. Despite, the importance of a family gathering and the need for knowledge about end-of-life care were confirmed. The survey (response rate 100%; n ¼ 92) showed that 90% of the respondents thought dying was a normal part of life and 76% felt comfortable talking about death. In conclusion, there was a shift in the Blackfeet Indians' attitude toward end-of-life discussion from reluctance to at ease. Recommendations specific to the Blackfeet-related entities are presented.

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“…Resources are available to assist clinicians in learning about different cultures and religions and to enhance awareness of how these can impact ethical decision-making. 19,[21][22][23][24][25][26][27] Consideration of cultural values and religious beliefs impacted with COVID-19 may have increased complications around EOL decisions and AANH. The limited presence of family members and faith leaders in the hospital setting may lead to patients feeling isolated at EOL and can impact healthcare decision-making around AANH.…”

Section: Cultural Values and Religious Belief Considerationsmentioning

confidence: 99%

Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper

et al. 2021

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The American Society for Parenteral and Enteral Nutrition (ASPEN) Position Paper focus is on applying the 4 ethical principles for clinician's decision-making in the use of artificially administered nutrition and hydration (AANH) for adult and pediatric patients. These basic principles are (1) autonomy, respect the patient's healthcare preferences; (2) beneficence, provide healthcare in the best interest of the patient; (3) nonmaleficence, do no harm; and (4) justice, provide all individuals a fair and appropriate distribution of healthcare resources. Preventing and resolving ethical dilemmas is addressed, with an emphasis on a collaborative, interdisciplinary approach. Optimizing early communication and promoting advance care planning, involving completion of an advance directive, including designation of a surrogate decision-maker, are encouraged. Clinicians achieve respect for autonomy when they incorporate the patient, family, community, country, geographical, and presumed cultural values and religious belief considerations into ethical decision-making for adults and children with a shared decision-making process. These discussions should be guided by the 4 ethical principles. Hospital committees and teams, limited-time trials, clinician obligation with conflicts, and forgoing of AANH are addressed. Specific patient conditions are addressed because of the concern for potential ethical issues: coma, decreased consciousness, and dementia; advanced dementia; cancer; eating disorders; and end-stage disease/terminal illness. Incorporated in the Position Paper are ethical decisions during a pandemic and a legal summary involving ethical issues. International authors presented the similarities and differences within their own country or region and compared them with the US perspective.

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Native American Death Taboo: Implications for Health Care Providers

Cited by 15 publications

References 26 publications

Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making

Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making

Moving Toward Openness: Blackfeet Indians’ Perception Changes Regarding Talking About End of Life

Ethical Aspects of Artificially Administered Nutrition and Hydration: An ASPEN Position Paper

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