Seven principles for Indigenous palliative care service delivery : research findings from Australia

In any society, the response to health and illness is shaped bycultural traits, values and rules and learned through participation in that society. In Australia, there are significant cultural differences in the way disease and death are dealt with and understood by the dominant Anglo-Australian society and by Aboriginal peoples. The implications of such cultural differences are particularly poignant during the dying trajectory. As palliative care has only recently begun to address the cultural needs of Indigenous Australians, there is scant literature available on the topic. In order to address this hiatus, the present article provides findings from a National Health and Medical Research Council two-year study on Indigenous palliative care conducted in the Northern Territory that documents a model for end-of-life care for Aboriginal peoples. The purpose of this article is to presentthe findings informing the seven principles (equity; autonomy/empowerment; trust; humane, non-judgmental care; seamless care; emphasis on living; and cultural respect) that underpin the model. The articulation of the seven principles has been developed through extensive consultation with Aboriginal peoples and health professionals throughout the NorthernTerritory. As the principles have now been reviewed and affirmed by a diversity of national audiences, it is with confidence that the authors offer them as a practical starting point for ensuring that excellence in end-of-life care is provided for Australia’s first peoples. In so doing, it is the authors’ hope and expectation that the principles will provide insights for others working withIndigenous peoples around the world.