PubMed · 12580696
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Ruprecht Nitschke. 2003. Palliative program considerations.. https://pubmed.ncbi.nlm.nih.gov/12580696/
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Culture is a system of shared ideas, concepts, rules and meanings that underlies the way we live--and approach death. Cultural diversity refers to more than ethnic diversity: age, gender, sexual preference, capabilities, education, place of residence, and occupation (including the health professions) contribute to diversity of culture. Clinical decision making involves values and ethical principles, which are influenced by culture--not only of the patient but also of the carers and health professionals. Care of patients approaching death involves the whole healthcare system--but may need, from time to time, palliative care specialist input, including specialised cultural competence. Education and training of palliative medicine specialists in Australia needs to include a focus on cultural competence.
All Indigenous communities in Australia have a common heritage of loss. Indigenous death rates are much higher than those for white Australians. Indigenous people use healthcare services reluctantly, and palliative care services rarely. Cultural considerations that need to be respected include Indigenous understandings of disease causation, attributions of blame for sickness, the performance of ceremonies after death and the importance of dying on traditional lands. The involvement of Indigenous health workers in clinical care increases confidence in the healthcare system as a whole.
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