CULTURAL PLURALISM & ETHICAL DECISION-MAKING IN NURSING

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The broad objective of this research is to conduct an empirical investigation of cultural pluralism and ethical decision-making with a sample of patients with life-threatening cancer, their families, and their care-providers. Specific aims are to: (1) Identify and describe the major ethical decisions faced by cancer patients in the last months of life, as defined by the patients, family members and care-providers, (2) describe and analyze the process by which these ethical decisions are made in the course of therapy for advanced terminal cancer with a focus on the dynamics within the families and between families and care- providers, (3) describe and analyze the impact of specific bioethic innovations, such as informed consent and advanced directions on decision-making processes, (4) compare and contrast the decision-making process of Chinese-American, Hispanic American and White patients, (5) examine and analyze the relationship between descriptive ethical decision-making practices observed during this empirical investigation and the fundamental philosophical normative principles of bioethics. The problem of bioethics practice in a culturally plural society is largely unaddressed. Understanding how patients from varied cultural and ethnic backgrounds respond to ethical dilemmas and understanding the decision-making process that occurs is a major step in improving clinical practice. There is theoretical significance to ethical theory as well. Because no previous empirically grounded studies on this topic exist, this research is, of necessity, descriptive. The research design is comparative and longitudinal. Participant observation and in-depth semi-structured interviews and event analysis serve as data collection strategies.