Bioethics Blogs

End-of-Life Planning for African Americans: Big Challenges

Last night, PBS Newshour reported that while end-of-life planning is gaining favor with more and more Americans, lagging behind this trend are African-Americans, who research shows are more skeptical of options like hospice and advance directives.

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Here are a few excerpts:

SARAH VARNEY: African-Americans are more deeply religious than other racial or ethnic groups. Three out of four pray daily and more than half attend weekly church services. In many black churches, the belief is that only God, not a doctor or a patient, decides when a life ends.

SARAH VARNEY: There is an ideal image of a good death in America, a clearly worded legal directive reflecting a patient’s wishes, avoiding painful and unnecessary medical treatments. But that ideal image is often at odds with the realities of black spiritual life and the lessons African- Americans carry forward from their painful history.

As late as the mid-1960s, segregated hospitals were common, and legal, throughout the United States. Even in so-called mixed race hospitals, black patients were often housed on separate floors. The notorious Tuskegee syphilis study, a government-led experiment on black males, lasted until 1972 and killed more than 100 men.

Dr. Kimberly Johnson is a geriatrician and associate professor of medicine at Duke University. She says, for African-Americans, the history of abuse is not a cultural artifact. The toxic distrust of the health care system is still deeply felt today.

DR. KIMBERLY JOHNSON, Associate Professor of Medicine, Duke University: They receive care in facilities that were largely either segregated or facilities where they — they or their parents or their grandparents wouldn’t have been allowed to have received care.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.