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- Title
THE POSITION OF THE FAMILY OF PALLIATIVE CARE PATIENTS WITHIN THE DECISION-MAKING PROCESS AT THE END OF LIFE IN SINGAPORE.
- Authors
Krishna, Lalit
- Abstract
The position of the family unit within the decision making process at the end of life in the context of Singapore is frequently underplayed and poorly understood due in part to its complex interplay with almost every element of patient care. Yet clearly its elucidation is of utmost importance to health professionals involved in caring for the terminally-ill in Singapore. Not only is Singapore a melting pot of various cultures but also significant inter-ethnic variances arise as a result of coadunations of specific social, educational, cultural, religious, and financial factors. In general, the family plays a role of a surrogate in decision-making, a provider in financial matters, a psychologist, a care-giver, a minister to spiritual needs, and an executor of post-mortem wishes. Whilst these roles seem to translate across all ethnic groups and cultures in Singapore, some distinct differences are apparent which prevent simple generalisations being drawn. This is particularly the case given that significant variations occur even within each family irrespective of ethic group. This paper focuses on the decision making preferences of the dominant Chinese populous. A particularity of the Chinese population in Singapore is the significant interplay of elements of Christian, Confucian, Buddhist, Taoist, and Mohist beliefs in varying proportions. Of particular interest within this blending is the combination of Confucian ideals of familialism with western ideals of individualism, a combination which is relevant to palliative care teams involved in the patient's care as they endeavour to provide holistic care to both the patient and his family. Ascertaining the patients' and their families' position, beliefs, hopes, and goals of care is imperative to the provision of good, patient-centred care and the cornerstone of palliative care interventions. This paper will aid in positioning the role of the family within this concept and will provide ethical rationale for this assertion.
- Publication
Ethics & Medicine: An International Journal of Bioethics, 2011, Vol 27, Issue 3, p185
- ISSN
0266-688X
- Publication type
Academic Journal