Guidelines for Teaching Cross-Cultural Clinical Ethics: Critiquing Ideology and Confronting Power in the Service of a Principles-Based Pedagogy

Abstract

This paper presents a pedagogical framework for teaching cross-cultural clinical ethics. The approach, offered at the intersection of anthropology and bioethics, is innovative in that it takes on the "social sciences versus bioethics" debate that has been ongoing in North America for three decades. The argument is made that this debate is flawed on both sides and, moreover, that the application of cross-cultural thinking to clinical ethics requires using the tools of the social sciences (such as the critique of the universality of the Euro-American construct of "autonomy") within (rather than in opposition to) a principles-based framework for clinical ethics. This paper introduces the curriculum and provides guidelines for how to teach cross-cultural clinical ethics. The learning points that are introduced emphasize culture in its relation to power and underscore the importance of viewing both biomedicine and bioethics as culturally constructed.

Their view: difficulties and challenges of patients and physicians in cross-cultural encounters and a medical ethics perspective

“…A large body of literature has shown that healthcare professionals and patients often encounter challenges in their interactions due to differences in language, culture or (religious) value systems [ 41 – 44 ]. From a medical ethics perspective, difficulties of migrant populations have particularly been discussed in the light of cultural difference and its implications for a principle- based approach [ 45 ], for example when the principle of autonomy collides with the wish to act culturally sensitive due to differences in (understanding of) moral values as shown by Minkhoff [ 46 ]. However, the problem of mutual misunderstandings is interesting insofar as it seems to indicate a fundamental incongruence at a level below cognitive differences or differences in values.…”

Impact and educational outcomes of a small group self‐directed teaching strategy in a clinical neuroscience curriculum

“…Since each student had different learning styles as well as a broader range of capabilities, it is also possible that the SDCL in this study could have provided the opportunity for students to use different learning tools such as the use of drawing technology to analyze neural pathways with specific lesion sites as well as including the use of concept maps to solve problems and communicate the solutions to colleagues. These tools provided a thorough and spatial analysis of neural circuit pathways and the integration at appropriate brain, spinal cord, or basal nuclei levels (Brunger, ; Haidet et al, ; Kumar et al, ; Vidyarthi et al, ; Zhou et al, ). When students share and discuss clinical applications among themselves in self‐directed small group activities (Slotnick, ), this produces an empowering experience that allows students to think critically (Slotnick, ; Delisle et al, ; Orsini et al, ; Pfeiffer et al, ).…”

Facilitating Critical Self-Exploration by Global Health Students

“…Ideologies are typically religious, economic, or political in nature and may manifest as projections of power. 36 Across boundaries of culture and geography, ideologies often compete with each other. As such, it is worthwhile to ask the following questions:…”