Gender, Ethnicity Sway Choices for End-of-Life Care
When it comes to end-of-lifecare, researchers have known for some time that ethnic groups havedifferent perspectives on how they’d wish to be treated.
Now, a small study suggests there’s a gender gap even amongpeople of the same ethnicity.
Interviews with focus groups in Michigan revealed that femaleAfrican-Americans and Latinos are more likely to want doctors topull out all the stops to keep them alive. In contrast, men saythey’d prefer to be allowed to die, said lead author SoniaDuffy, research investigator with the Ann Arbor VA Medical Centerand the University of Michigan.
The researchers also found that Arab-Americans andAfrican-Americans have starkly different expectations of where theywant to spend their last days.
“For Arabs, going to a nursing home is the worst thing thatcould happen to you. The strong expectation is that your familytakes care of you,” Duffy said. “But African-Americanswere more comfortable going to a nursing home, as they did not wantto ‘burden’ their families.”
The findings appear in the January issue of the Journal ofthe American Geriatrics Society.
Duffy cautioned that the study is small. Researchers interviewed73 Michigan residents in 10 focus groups divided by ethnic orracial group — white, black, Latino and Arab-American — andgender. Their average age was 67.
Despite the study’s size, the findings suggest doctors needto consider ethnic, racial and religious factors when they talk tofamilies about end-of-life care, Duffy said.
The researchers asked focus group participants how they’dwish to be treated if they had six months to live.
Individuals differed greatly on the role of medical technologyin extending life. According to Duffy, there were big differencesamong men and women in the African-American and Latino groups.
“The men generally did not want extensive interventiondone. Dying with dignity was very important, and they didn’twant to be a ‘vegetable,’ ” she said.
Duffy added that many men appeared to feel that being dependentat the end of life was a threat to their masculinity.
By contrast, “women were more hopeful that God mightintervene and things might change.”
These types of gender differences suggest that spouses need tounderstand where each other stands on end-of-life issues, Duffysaid. “It’s important to get couples talking,”especially since women tend to live longer and often findthemselves making decisions for their partners.