Cancer Patients’ Preferences for Control at the End of Life

Abstract

The achievement of a death consistent with personal preferences is an elusive outcome for most people with cancer. Maintaining a sense of control is a core component of a dignified death; however, control might be a Western bioethical notion with questionable relevance to culturally diverse groups. Thus, the purpose of our study was to explore the meaning of control and control preferences in a group of racially and ethnically diverse patients with an advanced cancer diagnosis. Using a hermeneutic, phenomenological approach, we interviewed 20 patients with advanced cancer and uncovered two themes: (a) preferences for everyday control over treatment decisions, family issues, final days of life, and arrangements after death, vs. (b) awareness that cancer and death are controlled by a higher power. Although the sample included non-Hispanic Whites, African Americans, and Hispanics, participants shared common views that are characteristic of American cultural norms regarding the value of autonomy.