Grant: Operating Grant - Priority Announcement: Ethics

In recent decades, the primacy of respect for autonomy in Western bioethics has led to various legal requirements and formalized attempts to promote patients' self-determination and to protect them from potential exploitation. Nonetheless, our preliminary research shows that healthcare providers (HCPs) continue to face challenges in working with patients, long-term care residents, and families in making healthcare decisions that respect people's autonomy. This project will explore problems in the current practices of decision making and strategies to support patients/families of culturally diverse backgrounds as they determine appropriate care plans. Interviews and focus groups in Vancouver and Toronto with diverse patients and surrogates (Chinese-speaking, Punjabi-speaking, English-speaking, and Aboriginal communities) as well as HCPs will be conducted. This project will: 1. Achieve better understanding of decision making processes for patients of diverse backgrounds in complex healthcare situations; 2. Identify patients', families', and HCPs' attitudes towards individual and system barriers and successes in promoting supportive decision making; 3. Develop a needs assessment tool as well as supportive decision making guidelines that will facilitate complex decision making with/for diverse and vulnerable populations. As our healthcare system is presumably founded on equity and fair distribution of resources, this project will help to promote our system's ability to live up to the promises of universality and accessibility, two of the principles emphasized in the Canada Health Act of 1984.