Cross-cultural considerations in clinical ethics consultations
R. D. Orr, P. A. Marshall and J. Osborn
Loma Linda, University Medical Center, CA.
Cross-cultural encounters between patients and physicians are now
commonplace. Although increasing attention has been given to cultural
issues in clinical medicine, there has been little discussion of cultural
differences presenting as ethical dilemmas. We report four cases in which
such differences led to requests for ethics consultations. In analyzing
these cases, we identify four elements that are essential for successful
resolution of such dilemmas: (1) an ability to communicate effectively with
patients and their families; (2) a sufficient understanding of the
patient's cultural background; (3) identification of culturally relevant
value conflicts; and (4) a willingness to pursue discussion of the ethical
dilemma until a compromise is reached or an otherwise satisfactory
resolution of the problem is achieved. We conclude with several practical
guidelines for clinicians facing ethical dilemmas in cross-cultural
interactions with patients.
