The heath care system in the United States is based on specific cultural beliefs that are sometimes inappropriate with groups that have different belief systems. These cultural differences can be seen in various end-of-life situations. To familiarize providers with some of the ways that culture can influence end-of-life care and decisions, the authors focus on the following three individual characteristics shown to be important in the literature: age, ethnicity, and gender. The article contains a broad overview of the (a) documented differences in the cultural interpretations of the ethical meta principles (e.g., autonomy and respect), (b) provision of medical service in general and pain management in particular to different groups, and (c) attitudes toward various end-of-life interventions and the use of advance directives. Finally, the authors summarize guidelines for making end-of-life care more culturally sensitive, which emphasize that each person must be interacted with as a unique individual.
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