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Qual Health Res. 2011 Dec;21(12):1618-31. doi: 10.1177/1049732311415287. Epub 2011 Jul 6.

Cancer patients' preferences for control at the end of life.

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  • 1University of Texas at Austin, School of Nursing, Austin, Texas 78701, USA. dvolker@mail.nur.utexas.edu


The achievement of a death consistent with personal preferences is an elusive outcome for most people with cancer. Maintaining a sense of control is a core component of a dignified death; however, control might be a Western bioethical notion with questionable relevance to culturally diverse groups. Thus, the purpose of our study was to explore the meaning of control and control preferences in a group of racially and ethnically diverse patients with an advanced cancer diagnosis. Using a hermeneutic, phenomenological approach, we interviewed 20 patients with advanced cancer and uncovered two themes: (a) preferences for everyday control over treatment decisions, family issues, final days of life, and arrangements after death, vs. (b) awareness that cancer and death are controlled by a higher power. Although the sample included non-Hispanic Whites, African Americans, and Hispanics, participants shared common views that are characteristic of American cultural norms regarding the value of autonomy.

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