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13 Cardozo J. Conflict Resol. 379 (2011-2012)
A Case of Conflict of Cultures: End-of-Life Decision Making Among Asian Americans

handle is hein.journals/cardcore13 and id is 383 raw text is: SYMPOSIUM A CASE OF CONFLICT OF CULTURES: END- OF-LIFE DECISION MAKING AMONG ASIAN AMERICANS Pat K. Chew* I. INTRODUCTION Our culture is the lens through which we see the world.' It provides an explanatory model for the way we think and the way we behave. It indicates our values and norms, even when we are not deliberately thinking about them. It shapes the logic we have for explaining life experiences and influences our decision making. Culture is especially relevant during key life events, such as births, marriages and deaths. Culture is clearly salient during end-of-life decision making.2 This essay presents a case example of a conflict between two cultures. One culture is the U.S. mainstream culture, as illustrated in a federal statute, the Patient Self-Determination Act.3 This stat- ute provides legal guidelines for health care providers dealing with individuals' end-of-life decision making. Lawyers and health care providers refer to these guidelines in their counseling and treat- ments, apparently assuming that these guidelines are in the best interest of those they serve. The other culture is Asian American culture and its approach to end-of-life decision making. As this es- * Judge J. Quint Salmon and Anne Salmon Chair and Professor of Law, Distinguished Faculty Scholar, University of Pittsburgh School of Law. 1 Kevin Avruch & Peter W. Black, Conflict Resolution in Intercultural Settings, in TIen CON- iiuicr & Cuitrune READR 7-11, 8 (Pat K. Chew ed., 2001); Simon Dein, Explanatory Models of and Attitudes Toward Cancer in Different Cultures, 5 LANC 'rONCOLOGY 119 (2004) (describing how culture determines how patients understand and explain cancer). 2 Matthew T. Gailliot et al., Mortality Salience Increases Adherence to Salient Norms and Values, 34 PERSONALIrY & Soc. Psycuoi. Bui. 993 (2008); Durairaj Maheswaran & Nidhi Agwaral, Motivational and Cultural Variations in Mortality Salience Effects: Contemplations on Terror Management Theory and Consumer Behavior, 14 J. CONSUMER PSYCHOJL. 213 (2004); Christine Ma-Kellams & Jim Blascovich, Culturally Divergent Responses to Mortality Salience, 22 Psycmo.. Sc. 1019 (2011). 3 The Patient Self-Determination Act is found in the Omnibus Budget Reconciliation Act of 1990, §§ 4206, 4751. It has been codified at 42 U.S.C. §§ 1395cc(a)(1)(Q), 1395mm(c)(8), 1395cc(f), 1396a(a)(57), (58), 1396a(w) (2011). 379

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