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The Chinese American population has grown rapidly in the last two decades. In the context of American healthcare, Chinese Americans have reported difficulties in reconciling traditional cultural beliefs with expectations for advance care planning. Cultural elements that fundamentally shape Chinese Americans' decisions regarding life-sustaining treatment are introduced in this article, including: the influence of acculturation, Confucian ethics, collectivism, familialism, male paternalism, filial piety, Confucian propriety and physician paternalism, the importance of dying with a full stomach, death as a cultural taboo, and the Chinese view of a good death. Healthcare providers who recognize these traditional cultural beliefs are better able to assist Chinese American patients and families in making end-of-life decisions in accordance with their cultural needs.