ABSTRACT: African American Perspectives on Pain and Palliative Care   [Print Version]

LaVera Crawley, MD
Stanford University School of Medicine
Oakland , CA

And

Richard Payne, MD
Duke Institute on Care at the End of Life
Duke Divinity School
Durham, NC

African American opinions about end-of-life care and decision making are shaped by contrasting views. On the one hand, African American religious and literary traditions celebrate a traditional Christian view of death as a welcomed friend. On the other hand, many African Americans struggle with the acceptance of high death rates resulting from the impact of disparities in health outcomes and insistent on life-prolonging treatments often are against the advice and wishes of their doctors. The impact of racially and socio-economically-based health inequalities, lead to considerations of the trustworthiness of the health care system, which can influence end of life decision making for African Americans. Community-based initiatives in palliative and hospice care are described which acknowledge these important perspectives, and offer models for improving access to care and the quality of end of life care.