Everybody is Dying but Nobody Wants to Talk About It: Addressing Disparities in Advance Care Planning for Black Oncology Patients

The topic of mortality is often avoided in American culture, with even greater resistance in the Black community. This challenge is exacerbated within the context of health care and serious illness, leaving Black patients and the clinicians that serve them ill-equipped to navigate end-of-life care. Despite death being the great equalizer, the experiences of those with life-limiting illnesses, especially cancer, vary greatly, with the impact of colonialism remaining evident in our perspectives on death and dying.

As research on supportive palliative care in oncology grows, discrepancies in utilization for people of color are evident. Black and Brown people with advanced cancer are less likely to participate in advance care planning talks and more likely to receive less than desired end-of-life care. To improve end-of-life care and outcomes for people of color, advance care planning (ACP) is essential.

This capstone includes three products aimed at addressing disparities in advance care planning for black oncology patients: a systematic literature review, a conceptual paper establishing a theoretical framework, and an application paper providing practical innovation to this grand challenge.