Questions that face dying individuals, their families, and the professionals that help them at the end of their lives are explored in this volume. The contributors help the reader to come to terms with issues of mortality complicated by the diversity of cultures within society.

End-of-Life Decision Making in American Indian and Alaska Native Cultures

End-of-life decision making in American Indian and Alaska Native cultures
Nancy WestlakeVan Winkle

Discussing end-of-life issues such as living wills, health care proxies, autopsies, and organ donations can be difficult for patients and health care professionals (Edinger & Smucker, 1992; U.S. General Accounting Office, 1995). When a largely non-Indian health care workforce is caring for an American Indian and Alaska Native population, differences in values, beliefs, and health care practices can make these discussions even more problematic (Hepburn & Reed, 1995). Even hospital policies for advance care planning that are mandated by the Patient Self-Determination Act of 1991 (PSDA) can raise ethical questions for some American Indian groups (Carrese & Rhodes, 1995).

Although some literature exists that discusses ...

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