Today's Dallas Morning News
reports on APPEAL – A Progressive Palliative Care Educational Curriculum for the Care of African-Americans at Life's End, a program developed at Duke University to promote better end-of-life care for African-Americans.
Blacks are more likely than whites to seek aggressive life-support treatments for loved ones facing terminal illness and less comfortable making decisions about withdrawing medical technology. Fewer blacks than whites state personal preferences with tools such as living wills or documents designating who should make their medical decisions when they can't.
Good deaths do not happen enough for African-Americans, because of discrimination, cultural and economic barriers, and lingering distrust of the health-care system. When clinicians tell black families that treatments aren't helping, they often fear they're being cut off for lack of money or insurance.
"You see patients struggling to come to terms," said Dr. Richard Payne, director of Duke University Medical Center's Institute on Care at the End of Life. "Minority families and African-Americans in particular have to cope with thoughts of, 'Would I be in this fix if I had better access to care?' Or, 'Can I trust this system that hasn't treated me very well?' Or, 'Are they treating me well, or is it a cost-saving measure?' Just to acknowledge these questions is a big step."
