'Palliative care': a contradiction in terms? A qualitative study of cancer patients with a Turkish or Moroccan background, their relatives and care providers
1 Medical Anthropology & Sociology Unit, University of Amsterdam, Oudezijds Achterburgwal 185, 1012 DK, Amsterdam, the Netherlands
2 NIVEL (Netherlands Institute for Health Services Research), PB 1568, 3500 BN, Utrecht, the Netherlands
3 VU University Medical centre (EMGO+), PB 7057, 1007 MB, Amsterdam, the Netherlands
4 Radboud University Nijmegen Medical Centre, PB 9102, 6500 HC, Nijmegen, the Netherlands
5 Pharos (Knowledge and advisory centre on refugees, migrants and health) PB 13318, 3507 LH, Utrecht, the Netherlands
BMC Palliative Care 2010, 9:19 doi:10.1186/1472-684X-9-19Published: 10 September 2010
Palliative cancer care aims to improve quality of life and ultimately quality of dying, while prolonging life is not an objective anymore when death nears. The question is, however, whether these perspectives on palliative care are congruent with the perspectives of immigrant families with a Turkish or Moroccan background.
A qualitative design was used as we were looking for the personal views of 'very ill' cancer patients with a Turkish or Moroccan background, their family members and their Dutch care providers. We interviewed 83 people, involved in 33 cases to obtain information about their views, values and norms on 'good care'.
The main concerns about 'good care' expressed by Turkish and Moroccan families were: maximum treatment and curative care until the end of their lives, never having hope taken away, devoted care by their families, avoiding shameful situations, dying with a clear mind and being buried in their own country. Their views conflict, to some extent, with the dominant principles in palliative care, for example, the emphasis on quality of life and advanced care planning, which includes discussing diagnosis and prognosis with the patient.
Patients and their families with a Turkish or Moroccan background often have different ideas about 'good care' than their Dutch care providers. As many of them are aiming at cure until the end of life, they find 'good palliative care' a contradiction in terms.