Culture, Ethics, and Advance Care Planning

Set against a backdrop of cultural diversity, the current emphasis on advance care planning, both in the United States and abroad, necessitates a sourcebook on how to navigate such complex terrain. This book will serve as a guide to best practice for advance care planning in a multicultural society. Such a guide will help those trying to engage in the often delicate discussions that take place during advance care planning to do so in a culturally sensitive manner. In addition, the book will provide general guidance in discussing difficult issues in a multicultural clinical setting. Given how entrenched advance care planning is in the medical context, to not attempt to engage in the process in a culturally sensitive way smacks of a dangerous indifference and sets the stage for conflict where calm could exist. In the fast-paced world of clinical medicine, recognizing and acknowledging differences in worldviews is often overlooked. When dealing with the delicate issues broached in advance care planning, such oversights can lead to deep rifts within the health care provider-patient relationship. This damage can be irreparable. By providing guidance to those engaged in such endeavors and setting advance care planning in a global context, health care practitioners will be better able to care for their patients and achieve the noble goal of advance care planninggiving volume to the voice of the patient in the last chapter of her life.

With the publication of Culture, Ethics, and Advance Care Planning, Alissa Swota has succeeded in providing something rare for philosophers of bioethics—namely, a well-grounded, practical guide to traversing the difficult terrain of advance care discussions in a multicultural environment. Replete with examples and cases, Swota's work will help equip any healthcare professional with useful insights, reminders, warnings, and tools that directly address the process of discussing end-of-life issues with patients and families. This is truly a needed addition to the fields of bioethics and healthcare delivery., In this timely book, Swota vividly describes the dilemmas that arise when the assumptions underlying advance directives clash with cultural values. Combining careful analysis with illuminating case studies, she clarifies the importance of cultural sensitivity in health care, and ends with practical suggestions for increasing cross-cultural communication. The result is a book that will be invaluable to scholars in bioethics, teachers of medical and nursing students, and health care providers in the clinical setting., Dr Swota takes us into the intersection of two complex issues in a medical practice with obvious dedication. Her book is appropriate for any medical professional or teacher of cultural competence....A worthwhile read for the subset of students, residents, and providers involved in either culturally sensitive education or end of life care or the fascinating intersection of the two.

Alissa Hurwitz Swota is assistant professor of philosophy at the University of North Florida and senior fellow in bioethics at the Blue Cross Blue Shield of Northeast Florida Center for Ethics, Public Policy, and the Professions.