Track 2-2a
Clinical

Hope And Harm: Ethical issues in the provision of palliative care to culturally diverse clients

Funded under a Australian National Palliative Care Project Grant, the project identified the needs of patients and carers from Arabic, Chinese, Italian and Vietnamese populations and of service providers working in palliative care. Information was obtained through 15 ethnic community focus groups comprising 237 participants, personal interviews with 44 patients and carers, and consultations with 42 service providers.
  The study yielded rich data concerning participants' perceptions about death, dying and bereavement and concerning expectations of service. Themes included: communicating bad news; hope; access to the patient including at the moment of death; preparation for death/spiritual care; care of the body; attitudes to service providers; use of interpreters and bilingual staff; staff support.
  Informed consent and telling the patient the "bad news" were among the ethical issues of note arising in the study. The first is of key importance to research involving people of non-English speaking background. Obtaining signed consent may create mistrust, impair open consultation and result in harm. The potential for harm may be greater for those of refugee background who may have been subject to threat, torture or other trauma associated with repressive regimes.
 Telling the bad news also emerged as an issue of serious concern. Participants report significantly decreased quality of life as well as shortened length of life following disclosure and loss of hope. Hope is perceived as the requisite element for prolonged life and for psycho-spiritual well being. The findings challenge traditional bioethical practice.

Ms. Gabriel Moore
Multicultural Education and Development Officer
Multicultural Health Service, Northern Sydney Area Health Service
Level 3, Vindin House
Royal North Shore Hospital
Pacific Highway
St. Leonards, NSW 2065 AUSTRALIA
Tel: 612 9926 6033
Fax: 612 9926 6710
gmoore@doh.health.nsw.gov.au

Gabriel Moore, BA (Hons.), Dip. Sp. Th., has lived and worked in Italy, England, Ireland and Australia. Her main areas of work include in professional development and adult learning, the strategic and operational management of client-focused services, management of change, and qualitative research with people of non-English speaking background. Since her return to Australia 5 years ago, she has worked in projects including an international study on the needs of others of terminally ill children; Alzheimer’s and dementia care in the Italian community of central Sydney; and she was the project officer for a major 2 year study entitled "Improving palliative care in a multicultural environment".
  In her current position as the Multicultural Education and Development Officer in Northern Sydney Area Health Service, Gabriel has designed and piloted cross-cultural training programs in a range of topics including aged care; management of a culturally diverse organization; cross cultural communication; culture and the health care transaction; policies and principles of cultural diversity. Courses have been designed to meet the needs of health professionals of a range of backgrounds and levels of literacy.   NEXT >

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