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Discussing dying in the diaspora: Attitudes towards advance care planning among first generation Dutch and Italian migrants in rural Australia

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  • Sinclair, Craig
  • Smith, Jessica
  • Toussaint, Yann
  • Auret, Kirsten

Abstract

Western cultural practices and values have largely shaped advance care planning (ACP) policies across the world. Low uptake of ACP among ethnic minority groups in Western countries has been interpreted with reference to cultural differences. This paper adopts a life-history approach to explore attitudes towards ACP among older, first-generation Dutch-Australian and Italian-Australian migrants. Thirty people participated in extended ethnographic interviews (N = 17) and group discussions (N = 13) during 2012. Transcripts were thematically analyzed and interpreted using a Foucauldian perspective on knowledge and power. Migration experiences, ongoing contact with the native country and participation in migrant community support networks influenced attitudes towards ACP. Dutch participants framed ACP discussions with reference to euthanasia, and adopted a more individualist approach to medical decision-making. Italian participants often spoke of familial roles and emphasized a family-based decision making style. The importance of migrant identity has been neglected in previous discussions of cultural factors influencing ACP uptake among ethnic minority groups. The unique migration experience should be considered alongside culturally appropriate approaches to decision-making, in order to ensure equitable access to ACP among migrant groups.

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  • Sinclair, Craig & Smith, Jessica & Toussaint, Yann & Auret, Kirsten, 2014. "Discussing dying in the diaspora: Attitudes towards advance care planning among first generation Dutch and Italian migrants in rural Australia," Social Science & Medicine, Elsevier, vol. 101(C), pages 86-93.
  • Handle: RePEc:eee:socmed:v:101:y:2014:i:c:p:86-93
    DOI: 10.1016/j.socscimed.2013.11.032
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    References listed on IDEAS

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    Cited by:

    1. Sok Shin Yap & Karren Chen & Karen M Detering & Scott A Fraser, 2018. "Exploring the knowledge, attitudes and needs of advance care planning in older Chinese Australians," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(17-18), pages 3298-3306, September.
    2. Zivkovic, Tanya, 2018. "Forecasting and foreclosing futures: The temporal dissonance of advance care directives," Social Science & Medicine, Elsevier, vol. 215(C), pages 16-22.
    3. John M. Friend & Dana L. Alden, 2021. "Improving Patient Preparedness and Confidence in Discussing Advance Directives for End-of-Life Care with Health Care Providers in the United States and Japan," Medical Decision Making, , vol. 41(1), pages 60-73, January.
    4. Zivkovic, Tanya, 2021. "About face: Relationalities of ageing and dying in Chinese migrant families," Social Science & Medicine, Elsevier, vol. 291(C).

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