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LaVera Crawley, MD; Richard Payne, MD; James Bolden, MPA; Terrie Payne, MA; Patricia Washington, DSN; September Williams, MD; for the Initiative to Improve Palliative and End-of-Life Care in the African American Community

JAMA. 2000;284:2518-2521.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

African Americans and other minorities underuse palliative and hospice care, even when they have access to this care. Statistics from the National Hospice and Palliative Care Organization indicate that African Americans represent 8% of patients who participate in hospice care, as compared with 83% whites.¹ Explanations for the underutilization of palliative care and hospice services by African Americans has engendered much speculation, but few data have been collected to further the understanding of this important problem. To provide the basis for solutions to correct this current state of affairs, reliable data and a broader societal dialogue are needed.

In response to this problem, the Initiative to Improve Palliative and End-of-Life Care in the African American Community was formed . . . [Full Text of this Article]

Barriers to Palliative and End-of-Life Care: Emerging Themes

History and Heritage

Religion and Spirituality

Socialization

Education

Bioethical Issues

Breach of Trust

Health Policy and Reimbursement Issues

Author Affiliations: Stanford University Center for Biomedical Ethics, Palo Alto, Calif (Dr Crawley); Memorial Sloan-Kettering Cancer Center, New York, NY (Dr Payne); Balm of Gilead End-of-Life Initiative of the Cooper Green Hospital, Birmingham, Ala (Mr Bolden); Harlem Palliative Care Network, New York, NY (Ms Payne); Department of Pain and Symptom Research, M. D. Anderson Cancer Center, Houston, Tex (Dr Washington); and the Tuskegee University National Center for Bioethics in Research and Health Care, Tuskegee, Ala (Dr Williams).

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