Chapter 3: Physician Cultural Attitudes Towards Hospice Services
From the Book: The Refractive Thinker®: Vol IV: Ethics, Leadership, and Globalization


Beneficence is a fundamental concept of medicine, which embodies the notion above all, do no harm. While this principle illustrates the healthcare professional’s duty to contribute to the patient’s welfare the principle becomes convoluted when the wishes of the patient directly conflict with that of the physician. The purpose of the study was to determine the degree to which cultural beliefs influence a physician’s decision to introduce the concept of hospice to terminally ill patients and to provide a referral if the decision is made to employ hospice services. The conclusions derived from this study suggest that an initial effort at understanding the perceptions of cultural beliefs of physicians in end of life decision-making may lead to an increased awareness of the cultural beliefs of their patients and need for improved education about end of life for both the physicians and patients. This qualitative phenomenological study guided by the modified van Kaam method of analysis explored the perceptions and lived experiences of 14 physicians practicing medicine in the Mercer County, New Jersey area. Analytical synthesis of the textural data revealed the following five themes: (a) physician personal perspectives, (b) physician perspectives on culture, (c) perspectives on hospice care, (d) communication with patients, and (e) training and experience. Study recommendations include the development of a peer-mentoring program to model communication skills to younger physicians and a hospital-based cultural competency education program to enhance physician-patient relationships within the community.
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