The challenge of cultural and ethical pluralism to medical practice

Abstract

“Culture” can be understood as the way in which people make sense of the world by deploying shared meanings, attitudes, assumptions and values. Doctors will frequently encounter patients whose lives are guided by ethical systems and values that are different from their own. Individuals may differ in their beliefs about decision‐making, regardless of their cultural background. Doctors should be willing to examine and test their own moral systems and cultural assumptions and be open to alternative traditions and beliefs. Engaging with other cultures does not imply that all cultural norms should be accepted uncritically, as there may not always be room for compromise. Failure to engage with issues of culture can erode the trust on which the doctor–patient relationship depends. Tensions can only be resolved through rigorous attention to a person's story.

Representations and coverage of non-English-speaking immigrants and multicultural issues in three major Australian health care publications

“…Of these, 10 were categorised as articles concerned primarily with multicultural health-related issues, 15 as moderately inclusive and 29 as having a minor mention of multicultural health issues. Examples of articles concerned primarily concerned with multicultural health issues included: an article outlining the importance of cultural competence in dealing with adolescents [68] or in medical practice [69]; an argument for the introduction of RU-486 in Australia [70]; a discussion of the forced detention of non-compliant TB sufferers [71]; discussions about the usage of complementary and alternative medicines and the need to introduce its study into medical schools [72,73]; a case study of a neonate with high lead levels associated with the mother's ingestion of herbal remedies [74]; a discussion of the legal and ethical implications of medically enforced feeding of detained asylum seekers who are on hunger strike [75]; concerns about the limited rights to healthcare of asylum seekers [76,77]; and an article detailing the trauma experienced by children and their families held in detention [78]. …”

Emergency Medical Practice: Advancing Cultural Competence and Reducing Health Care Disparities

“…Similarly, when providers do not carefully traverse cultural obstacles, patients may not receive the full benefit of medical treatment. These barriers arise when providers overlook the importance of culture and view it as something only relevant for the lives of “others.” 9–12 In reality, culture enriches one’s identity and provides a link to family and community through a common bond which informs “actions, expectations, and assumptions.” 9,11 For example, by allowing family members to be involved in decision‐making, a cultural preference can be respected to maximize beneficence. Cultural accommodations may enhance the practice of distributive justice through their ability to reduce barriers to care.…”

Glocalization of bioethics

“…Critics often point out that the standardization of bioethical principles and practices prioritizes western ideals and favours their imposition upon local resource-poor medical settings (Po-Wah & Lai, 2002 ). It is thus argued that because of its western biases, global bioethical governance cannot adequately deal with the moral and ethical complexity that is found in non-western, cultures (Brody, 1997 ; Irvine et al, 2002 ). This notion has been challenged in recent empirical studies on bioethical governance.…”