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Recognizing Chinese Americans' Cultural Needs in Making End-of-Life Treatment Decisions

Hsiung, Yi-fang Yvonne RN, MS; Ferrans, Carol Estwing PhD, RN, FAAN

Journal of Hospice & Palliative Nursing: May-June 2007 - Volume 9 - Issue 3 - p 132-140
doi: 10.1097/01.NJH.0000269993.13625.49

The Chinese American population has grown rapidly in the last two decades. In the context of American healthcare, Chinese Americans have reported difficulties in reconciling traditional cultural beliefs with expectations for advance care planning. Cultural elements that fundamentally shape Chinese Americans' decisions regarding life-sustaining treatment are introduced in this article, including: the influence of acculturation, Confucian ethics, collectivism, familialism, male paternalism, filial piety, Confucian propriety and physician paternalism, the importance of dying with a full stomach, death as a cultural taboo, and the Chinese view of a good death. Healthcare providers who recognize these traditional cultural beliefs are better able to assist Chinese American patients and families in making end-of-life decisions in accordance with their cultural needs.

Yi-fang Yvonne Hsiung, RN, MS, is a Doctoral Candidate, University of Illinois at Chicago, College of Nursing, Chicago, IL.

Carol Estwing Ferrans, PhD, RN, FAAN, is a Professor, University of Illinois at Chicago, College of Nursing, Chicago, IL.

Address correspondence to Yi-fang Yvonne Hsiung, RN, MS, University of Illinois at Chicago, Department of Medical-Surgical Nursing (MC 802), 845 South Damen Avenue, Room 745, Chicago, IL 60612 (e-mail:

© 2007 The Hospice and Palliative Nurses Association