The Ethics of Cultural Competence
For several decades, there was a push to increase "cultural competence" among health care providers. This effort importantly was a recognition that cultural values impact patients and their families understandings of their illness, their underlying motivations for health care decisions, and interpersonal relationships with their health care team. Certainly, understanding how groups of people, particularly those who are often marginalized, tend to experiences health and health care can be an excellent starting point and provide important background knowledge (indeed, this is the motivation behind the previous lessons which explore different marginalized groups). However, there are implicity assumptions rooted in the concept of "cultural competence" that may, ironically, undermine its very intentions. Please read the article by Michael Paasche-Orlow in which he discusses some of the potential missteps of the concept of cultural competence. As you read, think about ways in which you've seen beliefs and attitudes of patients that are rooted in culture play out in the clinical setting. Is it problematic to think of culture as a static thing that patients "have"?