A Hispanic client is diagnosed with inoperable brain cancer. The client's wife insists that any discussion about treatment options be postponed until all local family members are present. The nurse correctly views this as:
1. The family's attempt to facilitate a "good death'' for the client
2. An invasion of the client's right of confidentiality by the family members
3. Appropriate because the cancer may have affected his decision-making abilities
4. A cultural tradition that relieves the ill family member of the burden of decision making
ANS: 4
In some cultures, the group assumes decision making for a family member in these situations and is trusted to make the right decision for the individual. Indeed, some groups such as African Americans, Asian Americans, and Hispanics expect their family to make decisions for them, and family members prefer to protect the individual from unnecessary suffering by knowing the real-ity of imminent death. These cultures value group interdependence and view individual autono-my as an unnecessary burden for a loved one who is ill (Pacquiao, 2002, 2003a). The means by which the family provides a "good death" is first established through the process of group deci-sion making. It may appear that the client's confidentiality is being invaded by a member of the Western nursing profession; it is a cultural norm for members of many Hispanic families. Alt-hough cancer may affect the client's abilities to make decisions, the origin of this behavior is more likely the cultural tradition of group decision making among Hispanics.
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