A discourse of relationships in bioethics: Patient autonomy and end-of-life decision making among elderly Korean Americans

A two-year, multidisciplinary study (N = 800) was conducted on attitudes ab out end-of-life decision making among elderly individuals in four ethnic gr oups (African American, European American, Korean American, and Mexican Ame rican). On a quantitative survey, Korean Americans reported negative attitu des about the use of life-sustaining technology for themselves but positive attitudes about its use in general. This article reports on an interview w ith a 79-year-old typical Korean American respondent to explain the contrad iction in the survey data. Expectations among elderly Korean Americans incl ude protecting family members with a life-threatening illness from being in formed of their diagnosis and prognosis, and doing everything to keep them alive. Two conclusions, one substantive and the other methodological, are d rawn: First, the bioethics discourse on individual rights (patient autonomy ) is insufficient to explain the preferences of many Korean Americans and m ust be supplemented with a discourse on relationships. Second, the rigorous use of quantitative, narrative methods clarifies quantitative data and sho uld not be dismissed as "anecdotal,".