AHCPR-Supported Study Notes Differences Among Ethnic Groups in Attitude Toward Diagnosis of Terminal Illness

Press Release Date: September 14, 1995

According to a study published in the September 13, 1995 issue of the Journal of the American Medical Association (JAMA), there are striking "differences in the attitudes of elderly subjects from different ethnic groups toward disclosure of the diagnosis of a terminal illness, and toward end-of-life decision making."

The study, entitled "Ethnicity and Attitudes Toward Patient Autonomy," surveyed 200 subjects aged 65 years and older who were self-identified as being from each of four ethnic groups, including European American, African American, Korean American, or Mexican American. Researchers found that: "Korean Americans (47%) and Mexican Americans (65%) were significantly less likely than European Americans (87%) and African Americans (88%) to believe that a patient should be told the diagnosis of metastatic cancer. Korean Americans (35%) and Mexican Americans (48%) were less likely than African Americans (63%) and European Americans (69%) to believe that a patient should be told of a terminal prognosis and less likely to believe that the patient should make decisions about the use of life-supporting technology (28% and 41% versus 60% and 65%). Instead, Korean Americans and Mexican Americans tended to believe that the family should make decisions about the use of life support. Ethnicity was the primary factor related to attitudes toward truth telling and patient decisionmaking."

The researchers concluded that "Korean-American and Mexican-American subjects were more likely to hold a family-centered model of medical decision making rather than the patient autonomy model favored by most of the African-American and European-American subjects. This finding suggests that physicians should ask their patients if they wish to receive information and make decisions or if they prefer that their families handle such matters."

Note: For details refer to Blackhall LJ, Murphy ST, Frank G, et al. Ethnicity and Attitudes Toward Patient Autonomy. JAMA 274(10):820-825; September 9/13, 1995.

For assistance in arranging interviews or information on other AHCPR-funded research on issues related to cost, quality and access to health care, please contact AHCPR Public Affairs: Karen Migdail, (301) 427-1855.