At this stage of the process we have only been able to present preliminary results; still we hope that our experiences and considerations so far can be used as inspiration for health professionals who want to take up similar challenges. The study was supported by the Region of Southern Denmark and Lillebaelt Hospital. The sponsors were not involved in study design; in

collection, analysis and interpreting of data; in the writing of the report; and in the decision to submit the paper for publication. No conflict of interest. The authors want to thank the trainers from the Danish Medical Association AZD6244 molecular weight for their training of the local trainers. Also, thanks to the hospital management and the head of the departments for their commitment and for making it possible to implement the communication program at Lillebælt Hospital and to the check details Patient- and Hospital-secretariat for the excellent cooperation in the planning of the courses. Finally, thanks to all of the trainers at Lillebælt Hospital for their involvement in the program. “
“End-of-life (EOL) decision-making should be based upon patients’ values, beliefs, and preferences [1]. This standard emerged from 20th-century medical ethics and

health law strongly emphasizing respect for patient autonomy [2]. However, focusing exclusively on preferences or their implementation overlooks a more fundamental aspect of patient autonomy, respect for the patient’s preferred decision-making style [3]. The importance of decision-making styles is reflected in the literature on cultural competency, which emphasizes that patients’ preferred EOL decision-making styles can vary [4], [5], [6] and [7]. Race and ethnicity can also affect patients’ decision-making style, values, beliefs, and preferences, and thus impact end-of-life decision-making [8], [9], [10], [11] and [12]. Few studies of racially/ethnically diverse patients that examine EOL decision-making describe patients’ experiences beginning with their decision-making style and focusing on how patients

then progress in this process, and how EOL decision-making might vary by race/ethnicity. Physicians need to these understand how patients’ preferred decision-making styles shape their EOL decision-making, in order to assist them in this difficult task and to do so in culturally appropriate ways [13] and [14]. The goals of this qualitative study were to describe the self-reported decision-making styles experienced by seriously ill patients, how these affected their EOL decision-making, and to generate hypotheses about the relationship of race and ethnicity to that experience. This approach was open to the discovery of both commonalities and differences. After obtaining IRB approval through Baylor College of Medicine, participants were recruited through the Michael E. DeBakey VA Medical Center (MEDVAMC) in Houston, Texas.