As in so much of American life, the needs of dying patients who are racial and ethnic minorities, women, or poor have not been adequately addressed (Cleeland et al., 1997). Even hospice, which has successfully cared for thousands of cancer patients, has served primarily the white middle class (Brenner, 1997). Lifelong lack of access to preventive and curative services makes it difficult to persuade some patients that palliative care is more than "no treatment." Health care institutions' lack of minority staff may discourage patients and families from seeking or accepting available services. Health care professionals must be trained to meet the needs of patients and families in settings or cultures that are unfamiliar to them.
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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved.
For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].