Bridging worlds: A case-series on cultural challenges for second-generation oncological adolescents with palliative care needs

The role of the child and family’s cultural dimension in influencing healthcare experiences and outcomes has been increasingly recognized in pediatric palliative care (PPC). Therefore, a culturally sensitive project of care is essential to allow the person-centered, holistic, and tailored approach that characterizes PPC. However, this is not always easy. Second-generation immigrants have a unique social and cultural background and may face numerous challenges in balancing their bicultural identity. This report explores the complexities associated with shared decision-making and individual care planning within the realm of PPC across diverse cultural contexts. It employs an illustrative case series to emphasize the need to build bridges between different cultures within which the young person lives and finds balance. Serving as intermediaries for their families, they often endure uncomfortable and demanding roles, which results in a diminished awareness of their personal needs and concerns. Clinicians generally find it more effective to engage directly with the adolescent rather than with their parents, often presuming that the parents share values and beliefs similar to those of their child. However, such assumptions may overlook significant cultural and generational disparities. Delivering comprehensive support to adolescents within these dynamics is imperative, as it assists them in managing their intricate roles and navigating cultural disparities. Concurrently, enhancing clinicians’ awareness of these dynamics is vital for promoting a more culturally competent approach to care. This discourse emphazises strategies for effective communication and bridging cultural differences, outlining implications for practice and policy in multicultural environments.