تحلیل شرایط بیماران در آستانه‌ی مرگ، مراقبت‌های پایان حیات و اطرافیان بیمار مشرف به موت و توجه به توصیه‌های موجود

End stage patient control and autonomy are core principles in human bio-medical ethics and key components of end-of-life (EOL) care. Albeit, according to modern medical ethics principles the centrality of the patient as decision maker may not be relevant to culturally diverse groups of end stage people. The purpose of this article is to present results of a literature review of end stage patient control and their family position within the context of end of life support. The review revealed that the interaction between medical control and ethical values in end of life support is multifaceted and unpredictable. According to the recommendations of American College of Physicians/American Society of Internal Medicine End-of-Life Consensus Panel and some other world class medical and ethical societies, culturally effective end of life support includes the following essential elements • acceptance of and respect for cultural differences among all end stage patients • willingness to negotiate and compromise when world views differ • understanding of one's own values and biases • contact and communication skills that enhance empathy • information of the cultural practices of patient groups should be seen on a regular basis and • attention that all patients are individuals and may not share the same views as others within their own ethnic group According to the above description, applicants identified five domains of quality end of life support: 1. receiving adequate pain control 2. avoiding inappropriate prolongation of the dying process 3. achieving a sense of control 4. relieving burden on loved ones and 5. strengthening relationships We emphasize that, despite above mentioned points and advices maintaining a sense of control is an essential element in the end of life support for some individuals, further study of the interplay between ethnicity, desire for control, and achieving a good death is needed.