Abstract

This chapter explores the implications of differences in beliefBeliefs, religion, and cultureCulture, both among different family members and between families and health care providersProviders, and how these manifest in medical practice. The authors principally aim to provide a practical approach to ethical pediatric and cross-culturalCross cultural care. Acknowledging the complexity of the clinician-parentParents-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 communicationCommunication. It further provides a practical approach, centered on respect for persons that culminates in truly informed consentInformed consent and assentAssent, to managing conflictsConflict between families and health care workers. It delineates three principles by which to approach disagreements about care decisions: the best interest standardBest interest standard ; the family-centered approach; and the harmHarm principle. The chapter concludes with a discussion of cultural competenceCultural competence, viewed as health services that are culturally and linguistically sensitive as well as respectful of and responsive to the health beliefsBeliefs of diverse patients. It explores the notions of cultural safetyCultural, safetyand cultural humilityCultural, humility as two fundamental components needed to realize respectful and culturally competentCompetent care.