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An Anthropologist is a person who examines many aspects of people, such as biology and culture, in order to get a better understanding of human origins and the evolution of diverse beliefs and social conventions. In a nutshell: Anthropologists studies the human origins, development and even the human behavior.

Source:
https://www.yourdictionary.com/anthropologist

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Aboriginal people are the forefathers of their geographical country's first inhabitants. Their knowledge of land and water is passed down from generation to generation as living cultural understanding. Aboriginal people have created their own systems of ecological knowledge and understanding that reflect a live symbiotic relationship with the land and rivers of their traditional homeland properties. This expertise encompasses a wide range of systems, including biodiversity, climate, land, culture, and people. This expertise is founded on indigenous peoples' deep spiritual connection to Mother Earth, which taught them to reverence, humility, and reciprocity.

Source:
https://www.qm.qld.gov.au/Explore/Find+out+about/Aboriginal+and+Torres+Strait+Islander+Cultures/Land#:~:text=Aboriginal%20People%20are%20the%20ancestors,down%20from%20generation%20to%20generation.

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Proof of vaccination (via the Check-In QLD app) are required for your visit to our museums. Learn more. Aboriginal People are the ancestors of the original population of their geographical country (Australia). Their understanding of land and water is the living cultural knowledge that is passed down from generation to generation.

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How does the Aboriginal people feel about the White Settlers in Australia?

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How does the Aboriginal people feel about the White Settlers in Australia?

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When European colonists first arrived in Australia, they discovered an unfamiliar region populated by people they didn't recognize. Because the British did not comprehend the people's society and land tenure system, they claimed their land. Indigenous peoples, on the other hand, fought and continue to struggle for their land and life. Despite the fact that Aboriginal land rights were not recognized by British common law, many Aboriginal peoples maintained their claim and connection with the land. The history of these conflicts is rarely recorded, although hundreds of occurrences and thousands of individuals were engaged.

Random killings of Aboriginal people and massacres of groups of men, women, and children grew more regular as European settlers moved further away from the center of government. In 1838, at Myall Creek station in New South Wales, the most horrific slaughter happened. Cattle rustlers murdered twenty-eight Aboriginal persons in cold blood. Aborigines who were on "their" territory were frequently slaughtered by settlers. To make a life, many Aboriginal people relocated to the city. Discrimination and sickness awaited them here, with drunkenness being a particular threat.

Source:
https://vpsc.vic.gov.au/html-resources/aboriginal-cultural-capability-toolkit/aboriginal-culture-history/

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What sort of things do Aboriginal people value in their lives, and how does this affect the way Aboriginal people live?

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What sort of things do Aboriginal people value in their lives, and how does this affect the way Aboriginal people live?

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The things that Aboriginal people value are:
Family
The land and spirituality
The Dreamtime

How do these things affect the way of living of the Aboriginal people

The importance of family
Due to the fact family plays a very important role for the Aboriginal people they give it a high value. This means that all family is very close to each other and everyone knows who is what from each other. This is also for the children, they know via this way what the ancestors did for them.

The land and spirituality
The land has a strong spiritual importance for Aboriginal people. For an Aboriginal child, relationships include not just people, but also the land, the animals, the plants, the skies, the seas, the weather, and the spirits.

The dreamtime
The Dreamtime is the story about how everything is created in the universe and how the people are created, so how we are now. Due to there are many different Aboriginal groups with all different understandings and meanings about the universe, all those different stories give aspect that impacts daily life. The stories are taught to young children through storytelling, art, music, and ceremonies. When the children get older and understand the Dreamtime then the story's relationship with life experiences are explained. In this way, they know the importance of sharing and caring for the community.

Source:
https://www.supportingcarers.snaicc.org.au/connecting-to-culture/connections-to-value-and-belief/

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There are a lot of beliefs in the Aboriginal Spirituality because this is not one religion. But the various religions can be placed into categories, these are the main three:
1. The belief in animism
2. They are polytheistic because they believe there is a creator, but also may other spirits that control the world
3. Totems

The meaning of the religious are:
1. Souls and ghosts don't only exist within animals and humans but also in plants, rocks, and nature.
2. That they believe in different gods.
3. A totem connects people with a form of invisible energy. And via this way community feels very connected.

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Terms to know the belief that all things have souls and spirits that live after death animism- polytheistic- the belief in multiple gods monotheistic- the belief in one god reincarnation- the belief that an individual is reborn in another body after death totems- a method of preventing marriage between relatives. Totems represent the person's mythical ancestor, such as a plant or animal. Individuals with the same totem may not marry.
Key Beliefs
There is a large variety of beliefs within "Aboriginal Spirituality" because this is not one religion- it is more of a category that many different Aboriginal beliefs fall into. Here are some common beliefs:

1. The belief in animism

2. They are polytheistic because they believe there is a Creator, but also many other spirits that control the world.

3. Totems

Creation Stories
Turtle Island- This is a story about how North American was created. In this story there was a flood that covered the whole earth. Eventually, the animals began taking turns trying to reach the bottom of the water to grab some mud; perhaps the mud could build some land. In the end, a muskrat sacrificed its life and grabbed some mud. This mud was put on the back of a turtle, and then Sky Woman spread this soil until it was large enough to become North America.

The Raven and the First Man- A Haida story that says that humans used to live in the water in clamshells. The first land-bond humans were convinced by the Raven to leave the clamshell.

Another (unnamed) story claims that before there were animals, there were only humans. Eventually, some humans changed into the animals that they are today. This belief has created a very strong bond between Aboriginals and animals.

Ceremonies

Sweat Lodge

- Led by Shamans; men who were considered to be very close to the spirit world. For a price, (a.k.a. a trade for his services) he would heal the individual by "locating" and getting rid of what was wrong in their body

Potlatch Ceremony

Rituals

Sundance

Shaking Tent

Related Articles:

http://www.catie.ca/comp_e.nsf/TOC/A124D8675A625E3985256900005820FB?OpenDocument

http://home.ca.inter.net/~greenweb/GW71-Path.html
Bibliography:
Garbarino, Merwyn S. "American Indian." The World Book Encyclopedia. 75th ed. 1992.

The Grand Council of Treaty #3. The Creation Story-Turtle Island. 28 Jan. 2008. 25 Feb. 2008 < http://www.noaanews.noaa.gov/stories/s1119.htm>

.Moore, Ruth. Life Nature Library: Evolution. Canada: Time Inc., 1971.

Robinson, B. A. Native American Spirituality: Beliefs of Native Americans, from the Arctic to the Southeast. 13 Jan. 2008. 25 Feb. 2008 < http://www.religioustolerance.org/nataspir3.htm>.

Quinlan, Don. Exploring World Religions: The Canadian Perspective. Don Mills, Ontario: Oxford University Press, 2001.

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Terms to know the belief that all things have souls and spirits that live after death animism- polytheistic- the belief in multiple gods monotheistic- the belief in one god reincarnation- the belief that an individual is reborn in another body after death totems- a method of preventing marriage between relatives.

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According to the Aboriginal belief, the Dreamtime is the time when life was created. It tells the story about how came to be. The spiritual beings, the Aboriginals call them ancestors, created the natural world in the dreamtime. The natural world consists of all animals, plants, mountains, rivers etc. The ancestors either created these living things, or were/turned into the living things.

The dreaming not only tells the story on how life was created, it also tells the Aboriginals the way they are supposed to live. It tells them how to treat animals, how to live in harmony with nature, who you should respect and who you should marry and have children with.

Source: https://www.aboriginalcontemporary.com.au/pages/what-is-the-dreamtime-and-dreaming

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The Dreamtime is the period in which life was created according to Aboriginal culture. Dreaming is the word used to explain how life came to be; it is the stories and beliefs behind creation. It is called different names in different Aboriginal languages, such as: Ngarranggarni, Tjukula Jukurrpa. In the Dreamtime, the natural world-animals, trees, plants, hills, rocks, waterholes, rivers-were created by spiritual beings/ancestors. The stories of their creation are the basis of Aboriginal lore and culture. And are also what are often painted by Aboriginal artists.

In the lore, all living things were either the ancestors themselves, or were made by the ancestors. That is, a river may be an ancestor and may also be a creation snake.

The Dreaming explains how things came to be - why a rock is in a certain place or a particular shape, why the echidna has spikes, why the moon returns full every month, how kangaroos got their tails. [1]

The Dreaming also commands the rules and ways of being in Aboriginal culture. Dreaming stories explain these beliefs, such as: the lesson not to hurt animals; who one should marry and bear children with (according to the Aboriginal skin system), who one should not talk to (according to the Aboriginal skin system), how one should show respect in another's Country, how one should welcome strangers to your own Country. It dictates how one should behave in certain circumstances. These stories are the cultural rules and obligations Aboriginal people are expected to live by, within their culture.

The Dreaming is not static or linear. It is the past, but it is also the present and the future. The Dreaming it is constantly evolving to explain events and changes today, such as floods, storms and (negative and positive) occurrences in people's lives.

[1] In the 1980s Ashton Scholastic commissioned artists such as Pamela Lofts to work with Aboriginal leaders to make children's books based on Dreamtime stories.

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The Dreamtime is the period in which life was created according to Aboriginal culture. Dreaming is the word used to explain how life came to be; it is the stories and beliefs behind creation. It is called different names in different Aboriginal languages, such as: Ngarranggarni, Tjukula Jukurrpa.

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Aboriginal Australians. The Men of the Fifth World | Tribes - Planet Doc Full Documentaries

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How does the Aboriginal belief system differ from that of other Australians 

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How does the Aboriginal belief system differ from that of other Australians 

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Because the Aboriginal population has shrunk, the amount of people beleving in the Dreaming has decreased to less than 1% of the Australian population.  The biggest religion in Australia is Christian. Their believe about the creation of (live on) earth is different from different. But not only that, the aboriginals also have a different thought about the way to live. It is very important to live in harmony with the land/nature and only take what you can give back. This is a big difference with the way most Australians live today.

Source: https://en.wikipedia.org/wiki/Religion_in_Australia

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Belief system integrated in today's society

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Belief system integrated in today's society

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In today's society their belief system of the Dreaming is now a mix from Aboriginal beliefs and Christianity. Christianity is integrated in the Aboriginal belief system by forcing the Aboriginals to read the bible. Many Aboriginals were exposed to Christianity due to losing their homelands to the society. In today's society there are colleges that support the Aboriginal church and the development of the Aboriginal church. In the Constitution there are no rules of protection for minority religions. Generally this means that the High Court favors the major interests above the minority religions.

The church have changed their vision of Aboriginal religion in their services. They have several elements of the Aboriginal religion integrated in their services in church. They have a new way of reaching out to the Aboriginals which leads to incorporation of Christianity and Aboriginal religion.

Sources:
https://www.creativespirits.info/aboriginalculture/spirituality/aboriginal-christians-christianity
https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp9900/2000RP11

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In what way is this belief system transferred?

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In what way is this belief system transferred?

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In the education system there has been a request for an Aborigional curriculum. The main topics for this curriculum are the language and the knowledge of the Aboriginals. In the request there was also acknowledgement for the need to engage this curriculum with the Western education system. The request raised the arguing about learning different languages to people who need to improve their English language. The Department of Education did not respond to the request of an Aboriginal curriculum. The government think that it is an Aboriginal education crisis and not one for the Western education system to solve.

Source:
https://www.researchgate.net/figure/Visualising-the-integration-of-aboriginal-knowledge-and-Western-knowledge_fig4_314007743

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Australia’s indigenous people say they’re still suffering legacy of British colonialism - BBC News

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Why is the European colonisation of Australia and the events following it still a source of great distress to the indigenous population? Link this to their belief system and death rituals. 

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Why is the European colonisation of Australia and the events following it still a source of great distress to the indigenous population? Link this to their belief system and death rituals. 

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In the beginning when Australia was discovered by the Europeans, there were a lot of massacres. Everyone who the colonist found were killed in an awful way. Complete communities were killed by gunfire, pushed of cliffs or burned alive. And the slavery was a huge problem for the Aboriginals.
Due to fact that the Aboriginals have such a strong religious belief on the life and on death rituals they had back then strong problems with what happened. But nowadays, this is still a huge problem for the people there because Aboriginals believe in a life after death, it is important to them that the traditions in which they believe are taken into account. They strongly believe that maintaining relationships with loved ones is very important for when they enter the spirit world. To this end, they have established a number of rituals that may vary from community to community and family to family.
For example, one of these rituals is that the body must be buried within 24 hours or the body must not be left alone until the funeral. Another tradition may be that the family is present from the time of death. Due to the mass killings, this ritual cannot be performed and is, so to speak, disrupted the death rituals and beliefs.

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2234625/

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Language: English | French

Len Kelly, MD MClSc CCFP FCFP

Alana Minty

Abstract

OBJECTIVE

To understand some of the cross-cultural issues in providing palliative care to aboriginal patients.

SOURCES OF INFORMATION

MEDLINE (1966 to 2005), CINAHL, PsycINFO, Google Scholar, and the Aboriginal Health Collection at the University of Manitoba were searched. Studies were selected based on their focus on both general cross-cultural caregiving and, in particular, end-of-life decision making and treatment. Only 39 relevant articles were found, half of which were opinion pieces by experienced nonaboriginal professionals; 14 were qualitative research projects from nursing and anthropologic perspectives.

MAIN MESSAGE

All patients are unique. Some cultural differences might arise when providing palliative care to aboriginal patients, who value individual respect along with family and community. Involvement of family and community members in decision making around end-of-life issues is common. Aboriginal cultures often have different approaches to telling bad news and maintaining hope for patients. Use of interpreters and various communication styles add to the challenge.

CONCLUSION

Cultural differences exist between medical caregivers and aboriginal patients. These include different assumptions and expectations about how communication should occur, who should be involved, and the pace of decision making. Aboriginal patients might value indirect communication, use of silence, and sharing information and decision making with family and community members.

RÉSUMÉ

OBJECTIF

Tenir compte des questions interculturelles dans la prestation de soins palliatifs aux patients autochtones.

SOURCES DE L'INFORMATION

On a consulté MEDLINE (1966 à 2005), CINAHL, PsycINFO, Google Scholar et l'Aboriginal Health Collection de l'Université du Manitoba. On a conservé les études qui portaient sur les soins de santé interculturels généraux et plus particulièrement sur la prise de décision et les traitements en fin de vie. On a repéré seulement 39 études pertinentes, dont la moitié étaient des opinions anecdotiques de professionnels chevronnés non autochtones; 14 étaient des études expérimentales qualitatives du point de vue de l'anthropologie et des soins infirmiers.

PRINCIPAL MESSAGE

Chaque patient est unique. Certaines différences culturelles risquent d'apparaître lorsqu'on dispense des soins palliatifs à des patients autochtones pour qui la famille, la communauté et le respect de l'individu sont des valeurs importantes. Il est fréquent que la famille et la communauté participent aux prises de décision pour les questions portant sur la fin de vie et les cultures autochtones ont souvent des approches différentes pour communiquer les mauvaises nouvelles et maintenir l'espoir chez les patients. L'utilisation d'interprètes et de modes de communication variés ajoute au défi.

CONCLUSION

Des différences culturelles existent entre le personnel soignant et les patients autochtones. Mentionnons, entre autres, des croyances et attentes différentes sur la façon de communiquer et ceux qui devraient y participer et sur le rythme de la prise de décision. Le patient autochtones pourrait préférer communiquer indirectement, recourir au silence et partager information et prise de décision avec la famille et les membres de la communauté.

Terminally ill patients and their family members face difficult decisions. When medical staff members are not of the same cultural background as the patient, communication and decision making take on new challenges.1 This review was undertaken to see how the published literature could inform care delivery for dying aboriginal patients.

Data sources

MEDLINE (1966 to 2005), CINAHL, PsycINFO, and Google Scholar were searched using various MeSH headings, including American Indians; communication barriers; traditional medicine; health knowledge, attitudes, practice; terminally ill; right to die; palliative care; decision making; informed consent; advance directives; and organ transplantation. The Aboriginal Health Collection at the University of Manitoba Library was also searched.

Study selection

Three hundred articles were identified in the search. Most of the articles dealt with specific medical problems (eg, diabetes, tuberculosis, HIV), rather than end-of-life issues. Only 39 articles focused on death and dying or relevant cross-cultural medical caregiving.

The studies reviewed varied in size from fewer than 10 subjects to large population surveys. Of the 39 articles used, 15 were review or opinion pieces, and 14 were qualitative studies using interviews or focus groups. Three quantitative studies used observed interactions or surveys. Population surveys included the 1991 Aboriginal Peoples Survey (N = 25 122) and the 2003 Ontario First Nations Regional Health Survey (N = 1094). Article characteristics are outlined in Table 1 .1⁻39

Table 1

AUTHOR (YEAR)

NO. OF PARTICIPANTS (N)

TYPE OF STUDY

LEVEL OF EVIDENCE

COMMENTS

Most papers were written by nonaboriginal authors exploring various aspects of aboriginal beliefs. Relevant papers covered several of the following topics: palliative care and barriers to such care, end-of-life decision making, coping with death in the family or community, organ and tissue donation, and modern and traditional aboriginal health and healing.

Most research studies were qualitative. Salvalaggio et al and Macaulay suggest that community-based qualitative methodology might be the most appropriate cross-cultural methodology.23,33,34

Synthesis

Many traditional aboriginal perspectives differ from the viewpoints of other Canadians.27 Authors encountered various attitudes when studying end-of-life issues, demonstrating the variety of beliefs within aboriginal communities. Ellerby et al noted that some aboriginal patients valued the "maintenance of quality of life rather than the exclusive pursuit of a cure" and emphasized that "life is to be preserved and should be pursued whenever meaningful quality can be maintained."8 In contrast, Molzahn et al documented that some aboriginal patients believe medical intervention should be minimal and that the Creator determines the time of death.27 Diversity of beliefs might vary between and within aboriginal communities, owing to differences of "traditional, acculturated or religious perspectives."39 While generalizations are often inappropriate, some common themes documented below might be reflected in end-of-life issues.20,27

Respect

Several commentators identified the importance of family, community, and respectful interpersonal relationships to aboriginal culture.3,8,13,16 Browne's in-depth interviews of 5 Cree-Ojibway key informants from northern Manitoba found that actively listening and accepting others' decisions were important for successful interpersonal relationships.4 Brant, a Mohawk psychiatrist, identified the concept of non-interference in his opinion article.3 He suggested that many aboriginals believe that all people are entitled to make their own decisions. This high degree of respect for personal independence means that advising, persuading, or instructing is "undesirable behaviour."3

Elders might be participants in decision making, as they are highly respected in aboriginal communities. They are valued for their wisdom and experience3 and might be quite knowledgeable about medicinal herbs and spiritual matters.32 This respect for elders and healers can lead aboriginal patients to accept medical advice from physicians without question, out of respect for their parallel role as healer.3

Trust

Benoit and colleagues studied 36 aboriginal women living in Vancouver, BC, using participant observation, focus groups, and follow-up interviews.2 The women liked the informal nature of the services at their urban health centre. They preferred aboriginal staff and wanted more information available in areas of parenting and coping with family illness. They liked the fact that they did not have to give any personal medical information on their first visit. Once they had built trust with the staff, nurses, and physicians, then they could address their specific medical concerns.8 Kelly and Brown also found this importance of trust in their interviews with 10 Canadian physicians working with aboriginal patients.22 They learned that it often took years of working in the same community before patients really started to open up and discuss issues.

Similar comments were made in northern Quebec by women involved in a diabetes education program.7 They thought the group of researchers should have had more understanding of their Cree community before coming to teach them about gestational diabetes. They also thought more local people could have been involved in organizing the project.7

Family caregiving

Newbold reviewed the Aboriginal Peoples Survey of 1991 (N = 25 122) and learned that family or friends often care for disabled aboriginal patients, instead of involving external agencies.28 This might be due to the geographic remoteness of patients, financial barriers, or the personal importance of family. MacMillan et al had similar findings in 2003, analyzing the Ontario First Nations Regional Health Survey (N = 1094) compared with the National Population Health Survey (N = 4840).25 It is difficult to tell if this caregiving by family members is by choice or out of necessity.25 Most aboriginal patients would like to die at home13 but do not.31 Aboriginal northern Ontario community members (N = 216) cited inadequate resources, training, and time as contributing factors.31 Aboriginal patients in remote communities more commonly interact with nurses, social workers, and alternative health care providers than they do with family doctors. Aboriginal patients might, therefore, be more comfortable with nonphysician care providers.

Family involvement with the death of the patient

In the event patients are incapable of making their final wishes known and a substitute decision maker has not been appointed, health care providers might have to determine which family member acts as spokesperson. Hepburn and Reed found that a spokesperson often emerges without any formal intervention by caregivers.12

Some aboriginal people see death as a necessary part of the life cycle and are quite accepting.12,39 Terminally ill patients might feel that it is very important to say goodbye to loved ones before they pass away.31 This might relate to their belief in an afterlife and the importance of maintaining relationships with loved ones upon entering the spirit world.18,30

Once an aboriginal patient has passed away, there might be additional local cultural considerations. In aboriginal communities, news that someone has died is usually told simply, directly, and promptly.30 Views on the handling of the body vary by community and family. The review by Smylie et al presents several belief systems.37 It might be important for family and community members to be present at the time of death. The patient or family might request that the death take place in the home community. If this is not possible, the family might request to have the body returned to the community soon afterward. The family might ask to be directly involved in the preparation of the body, and some traditions even require that the body not be left alone until after burial or that the body be buried within 24 hours of death.26,37

The process of dying

Many traditional aboriginal cultures consider death to be very natural. For many aboriginal people, a "good death" is one where they meet death with dignity and composure.31 Dying this way implies a further experience of an afterlife.11 Focus groups in 10 northern Ontario communities further defined a "good death" as "during sleep, without pain, in a patient who had received proper care."31

There are several accounts of aboriginal patients seeming to know when they will die. This can allow them to prepare themselves both physically and spiritually. Some people die while dressed in particular clothing which family members believe were specifically worn as preparation for their journey. This knowledge allows them to say goodbye to their loved ones, thereby maintaining their important positive relationships.30

Most authors point out that dying is a uniquely individual process, and care must be taken to ensure sensitivity toward the specific patient's wishes.

Organ donation

Molzahn and associates conducted interviews with 14 members of the Coast Salish people in British Columbia regarding organ donation. They encountered a belief in the existence of spirits within each person: when aboriginal people die, they should be buried with a complete body and soul so that they are prepared for their next life.27 This concept was also discussed by Kaufert et al in their reviews, and by Verble et al in their study of data collected from routine organ donation meetings (N = 323).18,20,38 Molzahn et al also discussed the concept of spirit transfer: some of the participants believed that part of a donor's spirit might be transferred to the recipient during an organ transplantation.27

These body-wholeness and spirit-transfer values might be issues for aboriginal patients contemplating organ donation. Molzahn et al mentioned the large number of aboriginal people awaiting transplantation and the low donation rate. The need for an intact body and complete spirit at burial might be met by performing a cleansing ceremony before the procedure.27

Injury is the leading cause of death for aboriginal people, most from motor vehicle accidents.14 Evidence from United States general population shows that minority ethnicity lowers donation rates across many cultures.36 Molzahn et al pointed out that many aboriginal people do support organ donation but lack relevant information.27 In the United States, Callender and colleagues found that a community-based minority research program in Washington, DC, increased organ donation rates over a 17-year period, addressing awareness and "ethnically similar messengers" with "culturally sensitive messages."6 Even among the 14 interview participants of Molzanh and colleagues, there was considerable diversity of beliefs, and the authors acknowledged the paucity of Canadian research on barriers to and beliefs about organ donation in aboriginal communities.27

Grieving

The concept of grieving parallels culturally appropriate care. Aboriginal people express their grief in various ways. Some aboriginal cultures view outward expressions of emotion as inappropriate,20 and the apparent grieving period is often quite short.30 Some families hold sharing circles or other ceremonies to help with their emotional pain.20 A traditional healer is sometimes consulted to help bereaved families spiritually.26 Additional customs sometimes take place during the year following the death of a family member.11,30

Complications and barriers

Hotson et al interviewed 44 key informants including community residents, elders, northern physicians, and nurses.13 They identified some of the challenges to providing a high level of health care: geographic isolation, language barriers, and financial barriers. The remote nature of many reserves means less access to medical procedures and professionals, lack of inpatient facilities, lack of permanent nursing staff, and difficulty accessing medications.13 Physician turnover and inexperience can also play a role.28,35 Brown and Shultis found that nonaboriginal communities had more health care services than aboriginal communities of similar size and geographic remoteness.5

Physical distance might force patients to leave their families and communities and go to larger cities for medical treatment. Hospitalized patients often feel isolated and lonely without these supports,8,17,34 compounded by the unfamiliar atmosphere of a distant hospital.17 One author wondered if a history of "inadequate health care and broken treaties" might contribute to an undercurrent of suspicion of Western caregivers.39 Doctors' and aboriginal patients' communication styles often differ. Aboriginal patients might be comfortable with more silence than Western caregivers are.11,22,29

Discussion

This small literature set gave a consistent, incomplete picture of issues that can arise in dealing with end-of-life care for aboriginal patients and their families. Recurrent themes include the creative tension between individual care decisions and family and community values, the mind-body holistic conceptual framework, and geographic isolation and its effects on medical resources.

These themes have implications for communication issues: style and pace of discussions, use of interpreters, and involvement of family and possibly other community members. Cultural beliefs of respect, trust, and spirituality can also factor into end-of-life discussions.

Several electronic and library databases were accessed to find the studies considered in this review. Other excellent small research projects might not have been catalogued and were therefore not reviewed.

This literature review has been a useful starting point for development of a community-based research project in northwest Ontario in partnership with an aboriginal research institute. We hope to explore some of the issues identified in the literature and see how they apply in our region. This could inform development of culturally appropriate tools for stating end-of-life preferences, patient transfer to medical facilities, level of investigations and care, and organ donation. Community-based regional research might remove some barriers to effective communication about these important end-of-life issues.

Conclusion

Aboriginal patient care might involve unspoken beliefs about end-of-life issues typically unexplored by physicians. These discussions can involve interpreters, family, and other key community members. Family members as interpreters might not be the best choice in these situations. The interplay of patients' individuality and of community and family concerns presents challenges for caregivers. Generalities might be useful to inform physicians of the potential scope of individual variation in end-of-life discussions, but each patient and family needs to be addressed individually.

Levels of evidence

Level I: At least one properly conducted randomized controlled trial, systematic review, or meta-analysis

Level II: Other comparison trials, non-randomized, cohort, case-control, or epidemiologic studies, and preferably more than one study

Level III: Expert opinion or consensus statements

Notes

EDITOR'S KEY POINTS

Many aspects of traditional aboriginal perspectives differ from the views of other Canadians. These perspectives might affect decision making and provision of palliative care.

It is important to note that beliefs regarding end-of-life issues vary within aboriginal communities. The authors caution that the process of dying is uniquely individual. Care must be taken to ensure sensitivity toward patients' speci_c wishes.

Footnotes

This article has been peer reviewed.

Contributors

Dr Kelly and Ms Minty contributed to concept and design of the study; data gathering, analysis, and interpretation; and preparing the manuscript for submission.

Competing interests

None declared

References

21. Kaufert JM. Cultural mediation in cancer diagnosis and end of life decision-making: the experience of aboriginal patients in Canada. Anthropol Med. 1999;6(3):405-21. [ Google Scholar]

34. Salvalaggio G, Kelly L, Minore B. Perspectives on health: experiences of First Nations dialysis patients relocated from remote communities for treatment. Can J Rural Med. 2003;8(1):19-24. [ Google Scholar]

37. Smylie JA Aboriginal Health Issues Committee. A guide for health professionals working with aboriginal peoples: cross cultural understanding. SOGC Policy Statement. J Obstet Gynaecol Can. 2001;23(2):157-67. [ Google Scholar]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada

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End-of-life issues for aboriginal patients: A literature review

# data[].attributes.attachment_link.description
Language: English | French Len Kelly, MD MClSc CCFP FCFP Alana Minty To understand some of the cross-cultural issues in providing palliative care to aboriginal patients. MEDLINE (1966 to 2005), CINAHL, PsycINFO, Google Scholar, and the Aboriginal Health Collection at the University of Manitoba were searched.

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''DNA confirms Aboriginals have long lasting connection to the country''

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''DNA confirms Aboriginals have long lasting connection to the country''