Now, more than ever, medical students are taught to approach medical care through the lens of cultural competency and sensitivity. A nice perspective, written in Academic Medicine, can be found here. For me, cultural competency in medicine is treating patients with respect, dignity and in a fashion that is consistent with their personal, ethnic, and religious beliefs.
Once again, it appears that end of life doctor-patient discussions may be distorted by right wing reactionaries, with emotional sound bites likening end of life care to ‘death panels’ and government rationed health care. As recently reported, under new Medicare regulations, the government will reimburse physicians for office visits in which the focus is not a physical exam or EKG. Rather, the focus is on discussing options for end-of-life care, including advance directives to forgo aggressive life-sustaining treatment.
Providing end of life care, with treatments and measures specified and limited by the patient, in accordance with his/her wishes and beliefs, is culturally sensitive and competent.
Those who argue against doctor-patient discourse on end of life decision making, are, in fact, insensitive and culturally incompetent.
