cultural ethical issues in healthcare

We assume that acknowledging this view may contribute to a climate in medicine where the social perspective can become an integral part of what is considered relevant for an individual’s health. 2. For example, one physician concluded after a patient had not followed medical advice: “I am quite pragmatic here. Soc Sci Med. Terms and Conditions, — The Importance of Ethical Culture: Increasing Trust and Driving Down Risks, The Ethics Resource Center (2010) Quite startling findings to say the least to think that one’s environment in and of itself could actually cause someone to act unethically or even commit fraud. Distressing factors such as workplace-related issues or family issues were mentioned as common reason for not following medical advice.

Possessing the understanding that your own culture and beliefs (and biases) influence your interactions with patients. of a group of people." Cultural Values, Ethics, and Ethical Conflicts Cultural values refer to enduring ideals or belief systems to which a person or a society is committed. For example, one physician assumed his patient had heavily overstated his rheumatic pain: “Based on our results I wasn’t able to reconstruct [his pain] from having difficulties walking up to [using] the wheelchair.

When I come [home] in the evening, I am also tired, you know. BMC Med Ethics 19, 70 (2018). Should you wash your hands? -- Are workarounds ethical? -- Turfing, bending, and gaming -- Dirty hands and the semiclear conscience -- Problems of humanity -- Ethics without heroics : foreseeing moral problems in complex systems This detailed approach points to the importance of concordance for both, patients and physicians, and the importance of clinical relationships. 2007;19(2):60–7. As a co-author, SCH contributed to data analysis, data interpretation and to the revision of the manuscript. Hyatt A, Lipson-Smith R, Schofield P, Gough K, Sze M, Aldridge L, et al.

Cultural issues in obtaining consent. Dr. Slosar is director, ethics, Ascension Health, St. Louis. 1.

Ethical Issues in healthcare related to abortion are becoming increasingly relevant, as it provides an opportunity for discussion on various dimensions of contemporary healthcare.

There are numerous ethical challenges clinical leaders, health practitioners and patients face in healthcare. Some examples of common medical ethical issues include: The protection of private patient information is one of the most important ethical and legal issues in the field of healthcare. On the index day, KW met the patients in the entrance area of the respective clinic and accompanied them during all encounters they had with hospital staff (front desk staff, nurses, physicians and interpreters as required).

This connection is also consistent with basic socio-demographic information provided on patients presented in this study (Table 1). Every situation is somewhat different, and ethical dilemmas can arise even when a hospital has policies in place to address them. Mrs. Ramsarathan's case shows that cultural expertise exists, that it complements ethics expertise, and that it can aid in clinical management. Only two thirds (67%) of the Australian population were born in Australia. Ethical Issues in healthcare related to abortion are becoming increasingly relevant, as it provides an opportunity for discussion on various dimensions of contemporary healthcare. in the state of pre-contemplation [35]. https://doi.org/10.1370/afm.393. Relationship issues reported by patients included feelings of not being taken seriously or fobbed, lacking attention on behalf of physicians and feelings of discrimination. Altorfer A, Domenig D. Transkulturelle Kompetenz: Lehrbuch für Pflege-, Gesundheits- und Sozialberufe. This essay aims to discuss the various issues and ethical dilemmas that arise with regards to the consent of consumers. Good medical practice guided by genuine efforts to understand and meet the cultural needs and contexts of different patients to obtain good health outcomes, which requires: Having knowledge of, respect for, and sensitivity towards, the cultural needs of the community. Relevant observations were noted in the interview guide. can do?’” (I 29). Some of the physicians’ explanations on the reasons why patients did not follow their suggestions are reflected in the scientific discourse on social determinants of health: contextual medical knowledge is based on educational background, a vulnerability factor deeply influencing health outcomes [11, 38]. The Nuffield Council on Bioethics examines the current and potential applications of AI in healthcare, and the ethical issues arising from its use, in a new briefing note, Artificial Intelligence (AI) in healthcare and research, published today. al., "Important Health Care Issues for California Latinos: Health Insurance and Health Status," UCLA Center for Health Policy Research, January 2003. Please enable it to take advantage of the complete set of features! Or case studies to illustrate the ethical dilemmas encountered in working within the area of multi-cultural/ cross cultural/trans-cultural counseling. […]” (I 19). Nurses are beginning to recognize the importance of understanding the values, beliefs, and health practices of different cultures in order to provide care that is appropriate and culturally relevant to diverse patient populations. Found inside – Page 425MacLennan + Petty, Sydney, pp 137–52 Johnstone M & Kanitsaki O (1991) Some moral implications of cultural and ... 27(3): 185–91 —— (2008a) The problem of failing to provide culturally and linguistically appropriate healthcare. Within their culture, find out whether they prefer to make decisions as a group or if it is mostly up to the individual. and further revealed why he feared seeing high values: “I want to see that it [blood pressure level] is ok. Then I can go [home].

Patient Educ Couns. Part of You may offend the patient or you might witness something that differs from your beliefs/moral codes. provision of reproductive health care to adolescents, providers face ethical issues related to the fiduciary relationship (to act in the best interest of the patient and subordinating one’s own interest) between the provider and the adolescent patient (Katz & Webb, 2016, pg.

As of 2016, there were over 300 separately identified languages spoken in Australian homes. BY: JOHN PAUL SLOSAR, PhD. https://doi.org/10.1111/j.1365-2929.2006.02512.x. These issues are discussed in greater depth in Ethical Issues in Cancer Care (Kluwer, 1999). healthcare, how it could be used in the near future, and what ethical, social, and political challenges these current and prospective uses present. The National Center for Ethics in Health Care (NCEHC) is VA's primary office for addressing the complex ethical issues that arise in patient care, health care management, and research. There is much hope and excitement surrounding the use of AI in healthcare. 2000;50(6):813–28. Keywords: culture, ethics, mental health (https://www.bfs.admin.ch/bfs/en/home/statistics/population/migration-integration/by-migration-status.html) Accessed 02 July 2018, Ethikkommission Nordwest- und Zentralschweiz, Swiss National Advisory Commission on Biomedical Ethics. ues, and ethics in mental health care. on observations during clinical encounters, drawings on the setting, general observations about the setting) were filed. Every situation is somewhat different, and ethical dilemmas can arise even when a hospital has policies in place to address them. the Ref. How they and their family cope with suffering. Australian Bureau of Statistics 2016, ‘2071.0 - Census of Population and Housing: Reflecting Australia - Stories from the Census, 2016,’ ABS, viewed 9 July 2019. The APN is expected to provide excellent regardless of the work environment. Hirsh AT, Hollingshead NA, Ashburn-Nardo L, Kroenke K. The interaction of patient race, provider bias, and clinical ambiguity on pain management decisions. This text/reader performs two tasks: First, it provides a sound, comprehensive introduction to the field of conventional Western medical ethics; second, it introduces readers to cross-cultural perspectives related to these or similar issues ... Over the decade it took to uncover this story, Rebecca became enmeshed in the lives of the Lacks family—especially Henrietta’s daughter Deborah. Deborah was consumed with questions: Had scientists cloned her mother? mimicry, bearing) as well as interaction sequences according to social- (e.g. Salmon P, Mendick N, Young B. Integrative qualitative communication analysis of consultation and patient and practitioner perspectives: towards a theory of authentic caring in clinical relationships. Interview questions were supplemented with observations KW had made during the clinical encounter under examination [15, 31]. Technology has completely transformed how we work, shop, travel and communicate. Abstract: Health and social care profession is one of the most common professions in contemporary Britain. Yet, “study after study” validates this premise. Interviews with coded text sequences in the category set >difficulties and challenges< were analysed further for respective content: significant interview sections were marked and discussed among the authors. When he was asked to measure blood pressure during consultation, he measured a second and third time on his own initiative. I find this a little strange […] because I drink enough and she always says to me ‘[you have headache] because you must drink more.’” (I 2). Nurses also need to build an ethical assessment framework to support them in their delivery of appropriate genetic and genomic healthcare. Bern: Verlag Hans Huber; 2007.

Med Decis Mak. Ilkilic I. We have also sought the views of patients, their representatives, and members of the public. BY: Fr. GUIDELINE 3 . One patient explained his difficulties in taking the values at home: “You know, if you know about the risks [of high blood pressure] then you get upset. https://doi.org/10.1016/S0140-6736(12)61228-8. 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. Ethical and Bioethical Issues in. Johnstone, M & Kanitsaki, O 2006, ‘Culture, language, and patient safety: Making the link’. Ultimately, keeping these frameworks in mind and undertaking cultural assessments will help healthcare professionals provide safe and person-centred care to all people regardless of their race, ethnicity, culture or language. Cultural competence is also related to patient safety and risk management, he says.

difficulties in attributing expressed pain to physical symptoms) and with the role of male family members (e.g. Our role is to clarify and promote ethical health care practices throughout VHA and nationwide. Patients referred to these as well and mentioned difficulties in following the doctors’ suggestions, especially concerning medication, self-monitoring and adhering to follow- up appointments. The result could be declines in the quality of patient care; problematic clinical relationships; and moral distress, which is defined as knowing the right thing to do but not being allowed or able to do it. Carrillo JE, Green AR, Betancourt JR. Cross-cultural primary care: a patient-based approach. 2005;11(3):261–73. One issue that continues to influence the entire nursing profession is staffing inadequacies. 2008). Participant observation: a guide for fieldworkers. KEY TOPICS: Among the topics discussed in this book are complementary and alternative medicine; contraception and sterilization; infertility and assisted reproduction; and surrogate motherhood; genetic testing (screening and counseling); ... More than one-fifth (21%) of Australians spoke a language other than English at home (ABS 2016). Awareness of aspects of other people’s culture as well as understanding the client’s views and how they articulate their problems. An ethical issue can occur in any healthcare situation where profound moral questions of “rightness” or “wrongness” underlie professional decision-making and … Nurs Ethics.

The impression of not being taken seriously came up e.g. Cultural issues in compliance. The comparison of reported problems raises questions on how these issues relate to each other and how they impact a clinical relationship (e.g. Impact of migration on illness experience and help-seeking strategies of patients from Turkey and Bosnia in primary health care in Basel. Prochaska JO, DiClemente CC. Cultural competence is based on ethical principles and informs ethical decision making.

Data of the semi-structured interviews were evaluated content-analytically according to Mayring [32,33,34] using the qualitative analysis software MAXQDA for coding and analysis. Health care professionals continually face ethical and legal issues in the workplace, putting them at risk for burnout. This article uses a case study to describe a process that health care providers can use when faced with ethical dilemmas that arise when caring for patients from different cultures. Later, he specified what he had been missing: “[…] how you are feeling, comfortable, uncomfortable why and so on. DOI: 10.1300/J010v39n03_03 Corpus ID: 39885431. On the other hand, the most important areas of interest that are reported in this paper reflect those that have been mentioned in the literature. Cite this article. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. “National Strategy on Migration and Health” [21,22,23]), thus, aim at eliminating group-specific inequalities. van den Muijsenbergh M, van Weel-Baumgarten E, Burns N, O'Donnell C, Mair F, Spiegel W, et al. Sometimes these issues come from a patient's discomfort with treatment, refusal of treatments based on cultural or personal ideologies, or when patients and their families must make life … Accessed 02 July 2018. […] For example, if I ask, ‘does your wife have this and that’ he is not asking her but just says ‘no’.” (I 19). This book focuses on ethical issues faced by a variety of healthcare practitioners across the Anglophone African continent. Besides language barriers [12,13,14] the impact of ‘culture’ on cross-cultural communication and interaction has been shown [15,16,17]. This essay discusses the main ethical challenges of information technology in the health care sector. through marriage) and patients under 18 were excluded from the study. Bundesstrategie "Migration und Gesundheit 2008–2013". 2008;28(6):845–9. One patient who felt her physician had missed to catch up a specific point during consultation complained that she had not read the medical record properly even though she had had the time for doing so. When asked for the reasons why he didn’t self-monitor blood pressure at home, one patient, working in two jobs, revealed: “When I [get up] in the morning, I am tired. Dealing with non-fulfilment of medical recommendations was also linked to considerations about >responsibility<. Found inside – Page 91Cultural competence in healthcare relates to individual professionals, but also to organizations and systems. ... Ethical issues in oncology are magnified by several factors: the severity of the illness and the negative metaphorical ... 2005 May;14(5):546-54. doi: 10.1111/j.1365-2702.2004.01107.x. How they prefer to communicate about death and dying and diagnosis and prognosis. This major new work updates and significantly expands The Hastings Center's 1987 Guidelines on the Termination of Life-Sustaining Treatment and Care of the Dying. Then, in line with the observational grid, observations made during the clinical encounter, were brought up.

Ferwerda, J 2016, ‘How To Care For Patients From Different Cultures’, Nurse.Org, 15 September, viewed 9 July 2019. Psychological Association (2002) ethical code compel psychologists to work with cultural sensitivity and competence.

In: Bundesamt für Statistik (BFS); 2016. https://www.bfs.admin.ch/bfs/de/home/statistiken/kataloge-datenbanken/tabellen.assetdetail.3442531.html. The concept of professionalism which “requires that doctors adhere to certain principled responsibilities” [50] includes the responsibility to reach a shared understanding, in a sense that the patient makes an informed choice. As far as policy making is concerned, probably raising problem awareness is necessary first on both sides by introducing this concept.

And that is why I had the impression it was also a bit a primary gain for him.” (31). Found inside – Page 225Issues of ethics, however, should always be at the forefront of considerations. communication about these issues can be ... healthcare problems in other cultures. for example, is the need for breast augmentation a cultural issue? or a ... Next, text sections were coded, reduced and verified in several cycles. at their workplace). https://doi.org/10.1017/S0963180114000516.

The seemingly simple maxim of healthcare proves far more complex when considered in the context of rapidly advancing medical technology, constant budget constraints, and new health threats. Each involved staff member was also asked whether they were willing to be interviewed afterwards. These … and technological aspects of health care, there has been an increase in complexity of ethical issues faced in the health care service delivery [ 5]. Against the societal background of super-diversity [4, 5] communication and interaction in clinical encounters are increasingly shaped by linguistic, cultural, social and ethnic complexities. Which issues impact hospital administrators and clinical leaders the most? […] It wasn’t really connected [to the medical results].” (I 32).

Kleinman A, Benson P. Anthropology in the clinic: the problem of cultural competency and how to fix it.

Our role is to clarify and promote ethical health care practices throughout VHA and nationwide. Written informed consent was obtained from all interview partners in German, Turkish or Albanian. […] He needs a medical certificate, he needs - in his first consultation - he needs prescription for physiotherapy […] then he unexpectedly showed up in-between because he just got a little cold needing a recipe […] He always comes with a whole range of prescriptions [needed] but seldom [says] […] ‘Would you have any suggestions of what I (!) Psychological Association (2002) ethical code compel psychologists to work with cultural sensitivity and competence. One physician specified: “[the patient] he comes with quite concrete claims and relatively low own activity. “an inflammation”) in understanding his patient’s vociferous reactions on diverse moves during physical examination: “The problem is that it [the moves during physical examination] didn’t fit with her wailings. This volume uniquely explores such difficult topics and others at the intersection of clinical practice, policy, and bioethics in women's health care through a feminist ethics lens. These major issues as well as ways to manage them are as follows: Confidentiality - The protection of private patient information in the medical field is one of the most important ethical issues that may arise in the field of healthcare. © 2021 Ausmed Education Pty Ltd (ABN: 33 107 354 441), https://www.ausmed.com/cpd/articles/transcultural-nursing-australia, https://www.ausmed.com/cpd/articles/cultural-assessment, https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/2071.0...Data%20Summary~30, https://www.caresearch.com.au/caresearch/tabid/2446/Default.aspx, https://nurse.org/articles/how-to-deal-with-patients-with-different-cultures/, https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx. Within the dimension of the individual encounter the question of responsibility is more complex. Narayanasamy, A 2002, ‘The ACCESS Model: A Transcultural Nursing Practice Framework’. 3. Identifying and considering ethical issues in the health promotion intervention is important for both moral (adhering to ethical principles or cultural conceptions of what is right and wrong) and practical (producing the desired impact) reasons (Carter et al., 2011).From a moral perspective, one compelling argument is that since health … Cohen JJ. Ethical aspects surrounding some of the difficulties could be highlighted and should get more attention in clinical practice and research. But I KNOW the dangers of hypertension, diabetes and other diseases.” (I 7). Still, we have identified several emerging ethical issues in robotics and healthcare. After briefly describing the concepts of multiculturalism, cultural competence, and ethical theory, we present five clinical cases to illustrate the range of ethical issues faced by mental health clinicians working in a multicultural environment, including issues of therapeutic bound- Ahola-Launonen J. While we like to believe in the ideal that all Australians have access to a high standard of healthcare, this is not always the case. This is due to genetic differences, dietary, cultural, environmental, socioeconomic or a combination of all of these factors (Collins 2003 quoted by Engebretson 2016). Transtheoretical therapy: toward a more integrative model of change. A methodological discussion using exemplary studies. Another patient who felt rejected without having received medical help repeatedly was very clear on that matter: “[they might think] ‘anyway he won’t complain’, maybe because I am an Albanian. What illness and care mean to them and their family. ues, and ethics in mental health care. It is crucial to better understand the difficulties patients with migration background and healthcare professionals experience in their shared clinical encounters and to explore ethical aspects involved. Also, he admitted wondering to what extent this patient wished to be informed at all regarding improving his condition, saying: “Some […] informed patients, they also query by themselves […] and then you sense […] when you explain […] it falls on fruitful ground, they implement it. Reducing health disparities and achieving equitable health care remains an important goal for the U.S. healthcare system. Physician-assisted suicide is the act of intentionally killing oneself … Patients felt not being taken seriously (e.g. Registered Nurses' personal rights vs. professional responsibility in caring for members of underserved and disenfranchised populations. (e.g. At recruitment KW approached selected patients in the waiting area of the clinic, introduced herself as a PhD student conducting a study about cross-cultural communication. I don’t want to go home with one hundred fifty, one hundred sixty. Cultural competence is the integration and transformation of knowledge about individuals and groups of people into specific standards, policies, practices, and attitudes used in appropriate cultural settings to increase the quality of services; thereby producing better outcomes . Limited resources force tough choices in quality of care. The health care industry continually deals with the lives of individuals and is bound by the ethical and legal aspects that influence decisions of health care professionals in their clinical practice. BMC Medical Ethics The larger study including hospital staff, patients, nurses, and doctors, revealed diverse topics some of which were specific for different groups and others overlapping between them. These ethical issues can come in all shapes and sizes. The Ethical Intersection of Healthcare and Technology.

when insisting on prescriptions), patients’ pain expression (e.g. WL contributed to the interpretation of the data and revised the manuscript. 2012;86(2):135–6. Culture and ethnicity may influence one's physical development and exposure to health compromising environments and conditions. It is vital you adapt your practice to address the wants and reasonable expectations of the patient (Medical Board of Australia 2014). WHO European review of social determinants of health and the health divide.

Another patient revealed a difficult family situation and financial problems provoking distress and making it difficult to follow complex treatment instructions. physicians’ experiences of distance occurring alongside patients’ frustrations of not being taken seriously). Issues of health care quality and satisfaction are of particular concern for people with chronic conditions who frequently come into contact with the health care system. Found inside – Page 101Healthcare includes services of prevention, diagnosis, treatment, and other care intended to restore and maintain health. As we understand the term, “health ethics” concerns the morality of healthcare practices and other activities ... Manage cookies/Do not sell my data we use in the preference centre. Clinicians must understand how each patient’s sociocultural background affects health beliefs and … Health Place. 2015;16(6):558–68. 2011;11:187. https://doi.org/10.1186/1471-2458-11-187.

We have also sought the views of patients, their representatives, and members of the public. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. Nationales Programm Migration und Gesundheit 2014–2017. In todays’ super-diverse societies, communication and interaction in clinical encounters are increasingly shaped by linguistic, cultural, social and ethnic complexities. “Violating patient’s confidentiality can have legal and ethical consequences for healthcare providers.” Professionalism in medical education, an American perspective: from evidence to accountability. Outline ethical issues that impact the APN Ethical issues can impact the health care system in a variety of ways. The category >problems with patients’ behaviour in relation to doctors’ advice< included taking medication in wrong doses or at wrong times, insufficient or lacking record of blood sugar or blood pressure values or carrying respective records to the consultation. e2). 2009;19(6):687–98. The modules include high-quality video dramatizations and worksheets, and cover topics including: Traditional roles of family care. and technological aspects of health care, there has been an increase in complexity of ethical issues faced in the health care service delivery [ 5]. 2nd ed.

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