Abstract

The introduction of Advance Directives in the second half of the twentieth century allows patients to make end-of-life decisions while they are mentally and emotionally fit to do so. However, despite the efforts of health care professionals to get Americans to prepare Advance Directives, the response of Americans has been disappointing, even more so among Native Americans. This essay explains how Navajo traditionally conceive of death and dying and how Advance Directives and medical practices clashed with their conceptions. In an effort to encourage Navajo patients to complete Advance Directives at Fort Defiance Hospital medical personnel participated in cultural-sensitivity training and introduced Navajo-centered approaches for documenting end-of-life decisions and supportive care. This summary of the approach taken at Fort Defiance Hospital demonstrates the success of using culturally sensitive accommodations.