Ethnic and cultural aspects of palliative and end of life care

Historic migration and the ever-increasing current migration into Western countries have greatly changed the ethnic and cultural patterns of patient populations, and their families, across the life course. This chapter attempts to identify ‘differences that make a difference’ when individuals living with, and dying from, advanced diseases who are from black, Asian, and minority ethnic groups negotiate institutions and practices for palliative and end of life care. The World Health Organization’s definition of palliative care specifies two goals: improving quality of life of patients and families and preventing and relieving suffering. It identifies three ‘colour-blind’ strategies for meeting those goals: early identification, impeccable assessment, and (appropriate) treatment. Lastly, the definition addresses four domains of care: (1) problems related to pain, (2) physical conditions, (3) the psychosocial, and (4) the spiritual. This chapter specifically addresses these goals, strategies, and domains in relation to delivering quality palliative care in cross- or multicultural settings.