Cultural Competence in Ethical Decision Making

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Chapter 14: Cultural Competence in Ethical Decision Making

Culturally competent care addresses diversity.

Ethical practice grounded in social justice and human rights prevents health inequity.

Morals and philosophic beliefs are constituted within the social, historical, and cultural experiences of a society.

Contrasting Social Constructions of Morality #1

Ethics:

A moral philosophy that consists of beliefs and assumptions about what is right and wrong.

Prescribes the proper action to take in a given situation.

Translates moral philosophies into action.

Contrasting Social Constructions of Morality #2

Respect for autonomy has become the focal context for health care decisions in the United States and Canada.

Ethical principles are applied to ensure and maximize individual autonomy, veracity, and fidelity.

US Congress upheld autonomy for individuals through the:

Patient Self-Determination Act

Health Insurance Portability and Accountability Act (HIPAA)

Contrasting Social Constructions of Morality #3

Ethical Diversity and Principles

Ethical relativism: Emphasizes the need to examine the context of the decision because sociocultural differences influence whether an act is moral.

Ethical relativism states that what is right for one group may not be right for another.

Supported by Feminist Theory: The need for health care practitioners to develop empathy, compassion, and relationships that promote trust, growth, and the well-being of others

Contrasting Social Constructions of Morality #4

Ethical Diversity and Principles (cont.)

Communitarian ethic of care upholds collective decision making over individual autonomy.

Fidelity is the obligation to remain faithful to one’s commitments.

Veracity upholds the virtues of being honest and telling the truth.

Nonmaleficence: cause no harm; focus on client safety emphasizes prevention of harm.

Beneficence: benefit consumers of care.

Question #1

Providing a client with informed consent upholds which ethical principle?

Autonomy

Ethical relativism

Veracity

Beneficence

Answer to Question #1

C. Veracity

Rationale: Informed consent requires veracity of information presented to clients and fidelity of practitioners to professional standards.

Ethics and Health Disparities #1

Health disparities are a chain of events signified by a difference in social determinants of health:

Environment

Access to care

Utilization of care

Quality of care

Health status or outcome

Ethics and Health Disparities #2

Patterns of morbidity and mortality are linked with social inequalities.

The association between social inequality and health disparity is observed worldwide.

Ethics and Health Disparities #3

Affordable Care Act (2010)

Expands health care coverage to most US citizens and permanent residents by requiring most people to have or purchase health insurance.

Provides free access to most preventive services and drug coverage for eligible seniors.

Includes subsidies to help people with low incomes comply with the mandate.

Intent is aligned with ensuring greater access to health insurance and care services by Americans.

Question #2

Is the following statement true or false?

The ACA is the solution for issues surrounding healthcare access and care for Americans.

Answer to Question #2

False

Rationale: The ACA attempts to ameliorate some of these problems but there are other considerations beyond access to health care services. Poverty, racism, residential segregation, and environmental injustices need to be addressed squarely in order to prevent and remedy their consequences for health and quality of life.

Culturally Competent Ethical Decision Making #1

Globalization has heightened the need for health professionals to have a worldwide perspective and assume an ethical–moral obligation.

Culturally competent compassion is immersed in balancing the rights of the vulnerable with those of others.

Culturally competent care promotes health equity for vulnerable and disadvantaged individuals and populations through social justice and protection of human rights.

Culturally Competent Ethical Decision Making #2

Human rights

Human rights aim to protect the inherent dignity and equal and inalienable rights of all people.

The right to health is a free-standing human right.

The Universal Declaration of Human Rights, 1948

Culturally Competent Ethical Decision Making #3

Social justice

Social justice focuses on the social consequences and responsibility for actions by the society or the government.

Relates to the fair, equitable, and appropriate treatment or use of resources.

Culturally competent care for vulnerable populations is achieved by commitment to both principles of social justice and human rights.

Culturally Competent Ethical Decision Making #4

Maintaining human rights and social justice requires:

Advocacy for social justice and human rights requires collaborative partnerships with individuals, families, and communities.

Multisectoral collaboration that attends to the whole spectrum of individuals and communities

Multilevel community partnership

May use culturally congruent action models

Cultural preservation, accommodation, and repatterning

Question #3

Parents of preschool children are refusing vaccination due to the concern that the vaccine would cause more harm to their children than good. Which of the following culturally congruent action models would assist with negotiating?

Cultural preservation

Cultural accommodation

Cultural repatterning

None of the above

Answer to Question #3

C. Cultural repatterning

Rationale: Cultural repatterning means attempting to help individuals and groups change their way of life to achieve a healthy, safe, and meaningful existence.

In this scenario, cultural repatterning can be applied by using media, health experts, community leaders, and former patients to disseminate scientific information and facts about vaccination.

The post Cultural Competence in Ethical Decision Making appeared first on Infinite Essays.

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