Social-cultural factors in end-of-life care in Belgium: A scoping of the research literature

Abstract

Various sociocultural factors influence the provision of EoL care in Belgium. This country provides a unique opportunity to witness how euthanasia is put into practice when legalized, in a context where palliative care is also highly developed and where many health care institutions have Catholic affiliation, providing an important example to others. Attention to how the sociocultural context affects EoL care adds to the current evidence base of service provision, which is essential in the further development of EoL care.

Palliative Care Research – A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012

“…Both definitions emphasise the relief of suffering and an active total care based on alleviation of symptoms and problems of various types. The main research topics are broadly similar to the ones found in the Irish , British and Belgium reviews. One exception is that spirituality was explicitly found as a research topic in Ireland, while the Swedish research either conceptualised research topics into existential issues or integrated ethical, existential and spiritual dimensions as part of a holistic approach, for example, in the research topics of illness, symptoms, caring and communication in which the quality‐of‐life dimensions were also found to be integrated.…”

“…The claimed need for diversity in research designs and methods may be considered to have been both fulfilled and unfulfilled by the present review. The very low number of clinical intervention studies is to be regarded as a significant inadequacy for the development of practice informed by research evidence, which nonetheless appears to be similar in other reviews . The very limited number of intervention studies is particularly dissatisfying, as we now know the potential for the cautious use of nonblinded randomised controlled trials (RCT) design to present significant effects of palliative care – consequently calling for complex, well‐designed intervention studies.…”

Pushing boundaries-culture-sensitive care in oncology and palliative care: a qualitative study

“…While the number of published studies on patients' cultural needs and their perception of culture sensitivity in medical care has increased in the last decades, little is known about staff perceptions, attitudes, and approaches when dealing with migrant patients. Evidence of staff experience is a necessary basis for the improvements in culture‐sensitive care.…”

“…9,10 Other important culture-related variables relevant for palliative care include expression of pain, preferences for end-of-life discussions, family structures, and dying rituals. [11][12][13] While the number of published studies on patients' cultural needs and their perception of culture sensitivity in medical care has increased in the last decades, 14,17,18 little is known about staff perceptions, attitudes, and approaches when dealing with migrant patients. Evidence of staff experience is a necessary basis for the improvements in culture-sensitive care.…”

Trust increases euthanasia acceptance: a multilevel analysis using the European Values Study

“…[ 20 , 45 , 46 ]). Similarly, regarding the legalisation of euthanasia in Belgium, some experts pointed to the importance of high levels of trust in physicians and the health care system [ 47 , 48 ]. By the same token, Cohen et al [ 49 ] reasoned that euthanasia can be discussed seriously only in situations where there are high levels of trust in the health care system, and Battin [ 50 ] also mentioned that a rejection of euthanasia might be associated with distrust of physicians.…”