Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar;90(4):1716-1737.
doi: 10.1177/00302228221126257. Epub 2022 Sep 13.

Diversity in Advance Care Planning and End-Of-Life Conversations: Discourses of Healthcare Professionals and Researchers

Charlotte Kröger  1 , Özgül Uysal-Bozkir  2 , Mike J L Peters  2 , Annicka G M Van der Plas  3 , Guy A M Widdershoven  1 , Maaike E Muntinga  1
Affiliations

Diversity in Advance Care Planning and End-Of-Life Conversations: Discourses of Healthcare Professionals and Researchers

Charlotte Kröger et al. Omega (Westport). 2025 Mar.

Abstract

To meet the end-of-life needs of all patients, ongoing conversations about values and preferences regarding end-of-life care are essential. Aspects of social identity are associated with disparities in end-of-life care outcomes. Therefore, accounting for patient diversity in advance care planning and end-of-life conversations is important for equitable end-of-life practices. We conducted 16 semi-structured interviews to explore how Dutch healthcare professionals and researchers conceptualized diversity in advance care planning and end-of-life conversations and how they envision diversity-responsive end-of-life care and research. Using thematic discourse analysis, we identified five 'diversity discourses': the categorical discourse; the diversity as a determinant discourse; the diversity in norms and values discourse; the everyone is unique discourse, and the anti-essentialist discourse. These discourses may have distinct implications for diversity-responsive end-of-life conversations, care and research. Awareness and reflection on these discourses may contribute to more inclusive end-of-life practices.

Keywords: advance care planning; discourses; diversity; end-of-life care; end-of-life conversations; equity.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Similar articles

See all similar articles

Cited by

References

    1. Ahmed S. (2007). ‘You end up doing the document rather than doing the doing’: Diversity, race equality and the politics of documentation. Ethnic and Racial Studies, 30(4), 590–609. 10.1080/01419870701356015 - DOI
    1. Barrett N., Wholihan D. (2016). Providing palliative care to LGBTQ patients. Nursing Clinics of North America, 51(3), 501–511. 10.1016/j.cnur.2016.05.001 - DOI - PubMed
    1. Beringer R., M., Gutman G., De Vries B. (2021). Exploring and promoting advance care planning among lesbian, gay, bisexual, transgender, and queer (LGBTQ) older adults living in non-metropolitan British Columbia. Journal of Gay & Lesbian Social Services, 33(4), 407–426. 10.1080/10538720.2021.1885552 - DOI
    1. Bilmes J. (1986). The discursive approach. In: Discourse and behavior. Springer.
    1. Bloomer M. J., Walshe C. (2021). What mediates end-of-life care choices? The Lancet Public Health, 6(3), e139–e140. 10.1016/S2468-2667(21)00005-0 - DOI - PubMed

LinkOut - more resources