End-of-life care across Southern Europe: a critical review of cultural similarities and differences between Italy, Spain and Portugal

Arantza Meñaca, Natalie Evans, Erin V W Andrew, Franco Toscani, Silvia Finetti, Xavier Gómez-Batiste, Irene J Higginson, Richard Harding, Robert Pool, Marjolein Gysels, Natalia Monteiro Calanzani (Member of Consortium)

Research output: Contribution to journalArticlepeer-review

Abstract

Evidence from a range of sources demonstrates that end-of-life (EoL) care practices and preferences vary across countries; culture is consistently one of the main explanations given for this. In order to understand how cultural factors are used to explain similarities and differences in EoL care between Spain, Italy and Portugal, database and hand searches were performed and cross-cutting core themes identified. Similarities included higher proportions of people who wished to die at home than actually died at home, a persistent trend for partial disclosure in Italy and Spain, low use of advance directives, and low incidence of all medical EoL decisions (with the exception of terminal sedation) compared to northern European countries. The role of religion and the importance of family ties were the two main cultural factors used to explain the similarities. Further research is needed in order to interpret the important differences that were also found.

Original languageEnglish
Pages (from-to)387-401
Number of pages15
JournalCritical Reviews in Oncology/Hematology
Volume82
Issue number3
DOIs
Publication statusPublished - Jun 2012

Keywords

  • Advance Directives
  • Caregivers
  • Death
  • Decision Making
  • Humans
  • Italy
  • Patient Acceptance of Health Care
  • Portugal
  • Religion
  • Spain
  • Terminal Care

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