Prospective end-of-life decision-making: A study of Asian Indian Hindu younger and older adults

Abstract

The process of end-of-life decision-making involves the choice of treatment preference and decision-maker. This study examined Asian Indian Hindus' decisions to determine age and cultural effects within the context of socioemotional selectivity theory. Younger (N=100) and older (N=100) Asian Indian Hindus completed a questionnaire on end-of-life scenarios, Western and Indian acculturation and Hindu end-of-life values. Twenty participants were interviewed. Results of sequential logistic regression provide support for the emphases on positive emotional experiences as predicted by socioemotional selectivity theory, but did not indicate age effects. This was substantiated in the qualitative interview data as well as supplemental analyses with a sample of younger (N=64) and older (N=59) non-Hispanic Whites. Asian Indians were less likely to choose life-sustaining treatments than non-Hispanic Whites. Autonomy in decision-making was important to both ethnic groups. The discussion focuses on implications of these findings for socioemotional selectivity and the role of culture in end-of-life decision-making.