Filipino culture fosters values that enhance group harmony and smooth interpersonal relationships. Family cohesiveness serves as a driving force for shared decision making among family members in accordance with the patient’s needs. Clinicians could develop a family decision-making tree or algorithm.
A primary decision maker may not be designated prior to a health crisis. Decisions may be delegated to family members living outside the US, or birth order may be used to designate the decision maker (McBride, 2006; Tompar – Tiu & Sustento – Seneriches, 1995).
The clinician should ask questions such as: “Who should we talk to?” or “Who can help in making decisions about your treatment in the future?” Family members are often expected to make decisions or speak for older adults; those without any close relatives may rely on friends, clergy, or a trusted service provider.
In complicated situations, a “go-between,” such as a trusted friend (compadre/comadre), cleric or member of a faith organization, who is usually not a family member, may facilitate the interaction or dialogue.