Family or Community Belief, Culture, and Religion: Implications for Health Care

Abstract

This chapter explores the implications of differences in belief, religion, and culture, both among different family members and between families and health care providers, and how these manifest in medical practice. The authors principally aim to provide a practical approach to ethical pediatric and cross-cultural care. Acknowledging the complexity of the clinician-parent-patient triad, it provides examples of cases involving seemingly irreconcilable differences, as well as an approach to managing them, with emphasis on the need for mediation and continued communication. It further provides a practical approach, centered on respect for persons that culminates in truly informed consent and assent, to managing conflicts between families and health care workers. It delineates three principles by which to approach disagreements about care decisions: the best interest standard; the family-centered approach; and the harm principle. The chapter concludes with a discussion of cultural competence, viewed as health services that are culturally and linguistically sensitive as well as respectful of and responsive to the health beliefs of diverse patients. It explores the notions of cultural safety and cultural humility as two fundamental components needed to realize respectful and culturally competent care.