9 Jun 2015

Call for changes to Māori palliative care

9:13 pm on 9 June 2015

Some academics are calling for more rigourous training to ensure Māori receive better care at the end of their lives.

They say the current palliative care system does not do enough to cater to the cultural needs of Māori.

University of Auckland Professor Merryn Gott and her colleague Tess Moeke-Maxwell have spent the past five years researching end-of-life care for Māori and how it could be improved.

Professor Gott said, when it came to palliative care in Aotearoa, a one-size-fits-all approach was not effective.

She said the current hospice model was based on Western culture.

"There's actually a philosophy that underpins [it] and it's quite a Western philosophy about what good death looks like.

"Certainly there are some dissonances between that and what Māori would want for themselves at the end of life," she said.

"So I think there's a real need to understand the different, culturally nuanced needs of Māori at the end of life and to look at how services could be optimised to support those."

Ms Gott said Māori have special tikanga, or customs, around death that Western cultures do not understand because they don't have them themselves.

She said staff in hospitals, age residential care and hospices needed to be aware of that to provide more appropriate services.

Dr Moeke-Maxwell, of Ngāi Tai, said there remained a lot of ignorance about the cultural values that tāngata whenua adopted at the end of their lives.

She said greater training should be offered to those in the health sector so that they understand such values, as the need for kaumātua to have certain kai, go to special places or be buried in their urupā, or cemetery.

'We all have our own biases'

Māori health expert Rhys Jones said it was as much about training health care staff about their own culture, background and biases, as it was about teaching them tikanga Māori.

"It's quite a normal human thing that we all have our own biases and preferences, some of those are fairly conscious, others are more unconscious," he said.

"So we have these biases that actually do affect our practice and can, if we let them, lead to differential treatment of patients."

Dr Jones said those biases could lead to bad decision-making by health professionals.

"There are stereotypes around Māori patients as being non-compliant with medication.

"If we as health professionals have those preconceived ideas or stereotypes in our mind, that can sometimes play out in the decisions we make," he said.

"In a situation like that the doctor might be more likely to not prescribe a medication because they believe the patient won't take it or take it in the way it's intended to be taken."

Dr Jones said learning about these biases should be a part of the health education process.

The University of Auckland's Te Ārai Palliative Care Research Group will hold a hui to discuss the issue on 25 June.

Get the RNZ app

for ad-free news and current affairs