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Cultural competence refers to the ability to provide care to patients by taking into consideration their diverse values and behaviours including tailoring healthcare delivery to meet the patient’s needs. Cultural competence and ethical decision-making are two interrelated concepts that are central to services rendered by all healthcare professionals. Cultural competence is based on ethical principles, personal and professional experience, legal issues and morals and it informs ethical decision-making.
Cultural competence has been formalized in various professional codes of ethics, which require competent services to be afforded to everyone regardless of their cultural or linguistic background. Cultural competence has been given prominence by the developments that have occurred in the healthcare system, for example the use of evidence-based practice (Louw, 2016). This is coupled with the diversification of the health professional workforce. All these changes have necessitated research on how to increase cultural competence, which have revealed that culture affects the patients’ communication styles, their beliefs about health and attitudes towards healthcare, which affects certain aspects like the frequency of seeking medical attention (Louw, 2016).
Ethical Decision Making
Ethics are inherent in every healthcare profession and the various professionals are required to be knowledgeable on the rules that govern their practice. Ethical decision-making is a complex process grounded in various themes that facilitate the process of decision making in order to resolve ethical dilemmas (Louw, 2016). The decision-making process entails identifying and gathering the relevant information, identifying the relevant ethical issues and possible violations, identifying possible courses of action, identifying the need for external consultation and studying the impact of each action (Louw, 2016). Afterwards, a plan of action is developed and implemented.
When working with culturally diverse individuals, healthcare professionals collaborate with interpreters who act as cultural brokers. The healthcare professional is required to train interpreters working under their supervision on procedures and ethics. Cultural competence ensures that healthcare professionals understand and support their patients and families more effectively.
Implementing cultural competence in ethical decision making
One of the ways through which cultural competence can be incorporated in ethical practice is through evidence-based practice where healthcare professionals are required to have the necessary knowledge, skills and attitudes to provide competent care to their patients for a range of diverse cultures (Louw, 2016). A culturally sensitive ethical perspective is essential for good practice and professionals need to be made aware of strict adherence to professional ethical codes, which may result in ethical dilemmas when providing services to patients from diverse cultures (Louw, 2016). Healthcare professionals should be able to communicate effectively, understand their patients’ unique beliefs, and make decisions that meet the patients’ needs in a sensitive and effective manner.
Ethical dilemmas are caused by conflict between respect for autonomy and cultural sensitivity. Health care professionals are able to address ethical dilemmas through ethical decision-making frameworks, which begin with developing ethical sensitivity (Louw, 2016). The characteristics of ethical sensitivity include identifying the patient’s moral perception, putting oneself in the place of the patient in order to identify comparable reactions and having an awareness of the significance of ethical principles and the stakeholders’ needs and interests (Louw, 2016).
Healthcare professionals can similarly incorporate cultural competence in ethical decision making through using the International Classification of Functioning, Disability and Health (ICF), which provides the framework for the holistic assessment of patients (Naude, 2015). The ICF framework respects the patient’s autonomy and emphasize the importance of a healthcare professional’s ability to recognize how psychological factors influence the patients’ perceptions and expectations and how the psychological, social and environmental factors affects the patient’s perception of his ability to function as a member of society (Naude, 2015). This would enable healthcare professionals to develop their assessments and interventions based on the patients’ needs and this would ensure that patients gain confidence in them (Naude, 2015).
Instilling cultural competence and ethical decision making
Training has been suggested as the most effective way of ensuring cultural competence. Due to the importance of the ethics, healthcare professionals training programs are required by professional associations to include ethics where strategies on active listening, visualization of other people’s viewpoints and response to ethical issues (Louw, 2016). These strategies facilitate the development of an ethical framework that results in the development of ethical reasoning abilities. Moreover, ethical sensitivity can be developed through enhancing relationship skills that encourage other people to feel positive and engage in interaction and these skills facilitate the emotional regulation, which enhances effective ethical decision-making (Louw, 2016). Training on ethical sensitivity is important for students and healthcare professionals because it helps them resolve ethical dilemmas in ethical practice.
Training on cultural competence should integrate the understanding of ethical issues and these ethical issues need to be linked to the ethical principles of health care service delivery. This will lead to the better preparation of healthcare professionals to deal with conflicts in clinical practice.
Louw, B. (2016). Cultural Competence and Ethical Decision Making for Helath Care Professionals. Humanities and Social Sciences, 41-52.
Naude, A. (2015). Exploring ethical sensitivity in the SA context: Developing and Implementing a Measure in the Therapeutic Sciences. South Africa.