Advance Care Planning for African-American Faith Communities

The Center for Practical Bioethics has long worked on end-of-life issues and advance care planning. Research shows that palliative care and hospice are essential to address suffering and quality care for the seriously and terminally ill. Unfortunately, African-Americans typically do not share in the benefits of advance care planning, palliative care and hospice care to the same extent that white Americans do.

There are significant barriers to implementing advance care planning tools in African-American communities. Many harbor deep distrust of the traditional healthcare system stemming from egregious past ethical violations. Furthermore, African-Americans, who according to Pew Research Studies are the most religious racial group in the USA, have significant religious concerns about advance care planning. For example, a survey of 205 African-American patients showed that “African-Americans were more likely to express discomfort discussing death, want aggressive care at the end of life, have spiritual beliefs that conflict with the goals of palliative care, and distrust the healthcare system.”*

In November 2015, the Center began a two-year project to work with religious communities to address advance care planning in African-American communities. With funding from the John and Wauna Harman Foundation, we partnered with VITAS Healthcare to recruit nine churches in six cities to work on advance care planning in their congregations. These churches designated advance care planning ambassadors to teach about and advocate for advance care planning within their congregations.

In total, church teams from Atlanta, Chicago, Dallas, Kansas City, Philadelphia and West Palm Beach organized 19 events that reached nearly 700 people. More than 200 attendees committed to having conversations with their family members about advance care planning and end-of-life care. Nearly 100 individuals approached the presenters for more information and discussion following the event. Nearly 500 community members attended four conferences organized to celebrate these accomplishments.

The Center remains committed to improving end-of-life care for African-Americans by promoting advance care planning. We are planning the next stage of this project and look forward to meeting with our partners and other stakeholders in the next few months.

* Johnson K, Kuchibhatla M, Tulsky J., What Explains Racial Differences in the Use of Advance Directives and Attitudes Toward Hospice Care? Journal of the American Geriatrics Society 2008;56(10):1953-1958

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