Chinese seniors' perspectives on end-of-life decisions

Making end-of-life decisions is a painful and difficult process; one that c an be intensified by cultural differences between physicians and their pati ents. The objective of this study was to examine attitudes of Chinese senio rs towards end-of-life decisions. We conducted a qualitative survey in a Ch inese community centre in Toronto, Canada. Face-to-face interviews, in Cant onese. were conducted with 40 Chinese seniors 65 years of age or older. Res pondents based their end-of-life decision making on the following factors: hope, suffering and burden, the future, emotional harmony, the life cycle, respect for doctors. and the Family. Respondents rejected advance directive s. Respondents' attitudes toward end-of-life decision making can be underst ood through the lens of values from Confucianist, Buddhist and Taoist tradi tions. Health care workers can best achieve quality end-of-life care - and address the cultural differences that may arise - by focusing primarily on understanding the perspectives of patients and their families. and by conti nually striving for balanced and open communication at all stages of the ca regiving process. (C) 2001 Elsevier Science Ltd. All rights reserved.