Ethics Article 1

No longer accredited for CPD purposes

Ethics, culture and clinical practice

Northeast Florida Medical Supplement, January 2008

Robin N. Fiore, PhD


Issues of cross-cultural communication and diversity of moral beliefs not only impact patient satisfaction, but can also impact clinical outcomes. These considerations require us to work toward “cultural competency,” a topic increasingly included in the training of health professionals and administrators. Cultural competence is defined as “the level of knowledge-based skills required to provide effective clinical care to patients/clients from a particular cultural group.1 However, the ideal of cultural competency has proved to be both overly broad and vague with respect to its practice implications. In order to realize the benefits, specific guidance for practitioners is imperative. How ought we to approach ethical decision making when it involves parties of diverse ethnic and cultural backgrounds? Can it be right to come to different conclusions for different persons in very similar circumstance? What are the dangers of using racial and ethnic generalizations to inform clinical practices? In this article, I discuss best practices of cultural competency that can contribute to issues of specific concern to practitioners; issues that are regularly implicated in clinical ethics consultations: truth-telling, privacy and confidentiality, and patient self-determination, with specific reference to informed consent and end-of-life care

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