Demonstrating the importance of cultural considerations at end of life utilizing the perspective of Indian patients with cancer

Chittem, Mahati and Eliott, Jaklin and Olver, Ian (2022) Demonstrating the importance of cultural considerations at end of life utilizing the perspective of Indian patients with cancer. Supportive Care in Cancer, 30 (3). pp. 2515-2525. ISSN 0941-4355

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Purpose: This study aimed to understand Indian cancer patients’ hopes and beliefs about the end of life, particularly focusing on how this informed their preferences regarding end-of-life treatment. In India, individuals’ lives are mainly guided by culturally driven practices of doing right by one’s family and believing death is predetermined. Methods: Indian patients (25) diagnosed with advanced incurable cancer and aware of their prognosis participated in semi-structured interviews exploring their hopes as they approached the end of life. The interview also sought to understand patients’ views and beliefs about do-not-resuscitate (DNR) orders and euthanasia. The interviews were transcribed and analysed using interpretative phenomenological analysis. Results: Two major themes were identified: (i) a desire for living or dying comprising sub-themes of perceptions of current responsibilities, and having a fighting spirit versus feelings of despair, and (ii) God was the ultimate decision-maker of life and death. Furthermore, patients understood that a do-not-resuscitate order meant euthanasia and responded accordingly. Some patients reported hoping for death due to the pain and resultant suffering. However, patients did not talk about euthanasia openly, instead choosing to describe it within a larger framework of life and death. Conclusions: Indian patients reaching the end of life valued their family responsibilities which determined their desire to live or die. However, all patients believed that God decided on their life and death. It is important to consider cultural perspectives on DNR or euthanasia and to address patients’ pain management needs towards the end of life. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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IITH Creators:
IITH CreatorsORCiD
Chittem, Mahati
Item Type: Article
Additional Information: This study was funded by Cancer Council Australia.
Uncontrolled Keywords: Cancer; Do not resuscitate; End of life; Euthanasia; Hope; India
Subjects: Others > Medicine
Others > Psychology
Arts > Liberal arts
Divisions: Department of Liberal Arts
Depositing User: . LibTrainee 2021
Date Deposited: 18 Jul 2022 12:09
Last Modified: 18 Jul 2022 12:09
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