Abstract
The goal of this paper is two-fold. First, I begin by reviewing several of themajor points of emphasis among health educatorsas they begin to incorporate multiculturalissues into healthcare education. I thenconsider the role of moral relativism, which iscurrently being endorsed by some healtheducators, as the foundation for resolvingcross-cultural conflicts in healthcare. Iargue that moral relativism is ultimatelyinconsistent with the stated goals inmulticultural curricular proposals and fails toprovide an effective framework for consideringmoral conflicts in cross-cultural settings. Instead, I propose that those methods seekingto establish a common morality, built uponmutually shared values, offer the mostpromising means of resolving cross-culturalconflicts. This leads to my second goal, tocompare recent work in moral pragmatism withwhat is now widely known in bioethics as moral``principlism.'' I argue that while proponentsof principlism and pragmatism each seek toestablish a common foundation for moraldeliberation, they fail to appreciatesignificant similarities between theirrespective approaches. Instead of offeringtwo completely unique and independent methodsof moral deliberation, I suggest thatprinciplism and pragmatism embrace commonthemes that point us in a positive direction,providing an effective framework useful forconsidering cross-cultural conflicts inhealthcare.
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REFERENCES
American College of Obstetrics and Gynecologists. “ACOG Committee Opinion: Cultural Competency in Health Care.” International Journal of Gynecology and Obstetrics 62 (1998): 96–99.
Beauchamp, Tom L. and James Childress. Principles of Biomedical Ethics, 5th ed. New York: Oxford University Press, 2001.
Campinha-Bacote, Josepha, Tami Yahle, and Marci Langenkamp. “The Challenge of Cultural Diversity for Nurse Educators.” The Journal of Continuing Education in Nursing 27(2) (1996): 59–64.
Clinton, Jacqueline. “Cultural Diversity and Health Care in America: Knowledge Fundamental to Cultural Competence in Baccalaureate Nursing Students.” Journal of Cultural Diversity 3(1) (1996): 4–8.
Culhane-Pera, Kathleen A., Chris Reif, Eric Egli, Nancy Baker, and Rosanne Kassekert. “A Curriculum for Multicultural Education in Family Medicine.” Family Medicine 29(10) (1997): 719–723.
Dewey, John. “Democracy and Educational Administration.” School and Society 45 (1937): 457–462.
Dewey, John and James H. Tufts. Ethics. New York: Henry Holt and Co., 1932.
Dewey, John. The Public and its Problems. Athens: Ohio University Press, 1954.
Dewey, John. The Quest for Certainty. New York: Capricorn Books, 1960.
Donini-Lenhoff, Fred G. and Hannah L. Hedrick. “Increasing Awareness and Implementation of Cultural Competence Principles in Health Professions Education.” Journal of Allied Health 29(4) (2000): 241–245.
Fadiman, Ann. The Spirit Catches You and You Fall Down. New York: The Noonday Press, 1997.
Festenstein, Matthew. Pragmatism and Political Theory: From Dewey to Rorty. Chicago: The University of Chicago Press, 1997.
Fins, Joseph J. “Approximation and Negotiation: Clinical Pragmatism and Difference.” Cambridge Quarterly of Healthcare Ethics 7 (1998): 68–76.
Fins, Joseph J., Matthew D. Bacchetta, and Franklin G. Miller. “Clinical Pragmatism: A Method of Moral Problem Solving.” Kennedy Institute of Ethics Journal 7(2) (1997): 129–143.
Galanti, Geri-Ann. Caring for Patients from Different Cultures: Case Studies from American Hospitals, 2nd ed. Philadelphia: University of Pennsylvania Press, 1997.
Gewirth, Alan. “Is Cultural Pluralism Relevant to Moral Knowledge.” In Cultural Pluralism and Moral Knowledge. Edited by Ellen Frankel Paul, Fred D. Miller, and Jeffrey Paul, 22–43. Cambridge: Cambridge University Press, 1994.
Gillon, Raannan, ed. The Principles of Healthcare Ethics. New York: John Wiley and Sons, 1994.
Gouinlock, James, ed. The Moral Writings of John Dewey, rev. ed. New York: Prometheus Books, 1994.
Graber, Glenn, Alfred Beasley, and John Eaddy. Ethical Analysis of Clinical Medicine: A Guide to Self-Evaluation. Baltimore: Urban and Schwarzenberg, 1985.
Harman, Gilbert. “Moral Relativism Defended.” Philosophical Review 84 (1975): 3–22.
Kant, Immanuel. Groundwork of the Metaphysics of Morals. Translated and edited by Mary Gregor. Cambridge: Cambridge University Press, 1998.
Jansen, Lynn. “Assessing Clinical Pragmatism.” Kennedy Institute of Ethics Journal 8(1) (1998): 23–36.
Jecker, Nancy S., Joseph Carrese, and Robert A. Pearlman. “Caring for Patients in Cross Cultural Settings.” Hastings Center Report 25(1) (1995): 6–14.
Jennings, Bruce. “Possibilities of Consensus: Toward Democratic Moral Discourse.” The Journal of Medicine and Philosophy 16 (1991): 447–463.
Like, Robert, Prasaad Steiner, and Arthur Rubel. “Recommended Core Curriculum Guidelines on Culturally Sensitive and Competent Health Care.” Family Medicine 28(4) (1996): 291–297.
Macklin, Ruth. “Ethical Relativism in a Multicultural Society.” Kennedy Institute of Ethics Journal 8(1) (1998): 1–22.
McGee, Glenn, ed. Pragmatic Bioethics. Nashville: Vanderbilt University Press, 1999.
Moreno, Jonathan D. “Consensus by Committee: Philosophical and Social Aspects of Ethics Committees.” In The Concept of Moral Consensus: The Case of Technological Interventions in Human Reproduction. Edited by Kurt Bayertz. Dordrecht: Kluwer Academic Publishers, 1994, pp. 145–162.
Nüñez Ana E. “Transforming Cultural Competence into Cross-Cultural Efficacy in Women's Health Education.” Academic Medicine 75(11) (2000): 1071–1080.
Rachels, James. The Elements of Moral Philosophy, 4th ed. Boston: McGraw Hill, 1999.
Robins, Lynne, Casey White, Gwen Alexander, Larry Gruppen, and Cyril Grum. “Assessing Medical Student's Awareness of and Sensitivity to Diverse Health Beliefs Using a Standardized Patient Station.” Academic Medicine 76(1) (2001): 76–80.
Sherwin, Susan. No Longer Patient: Feminist Ethics and Health Care. Philadelphia: Temple University Press, 1992.
Sherwin, Susan, ed. The Politics of Women's Health: Exploring Agency and Autonomy. Philadelphia: Temple University Press, 1998.
Shweder, Richard A. and Edmund J. Bourne. “Does the Concept of Person Vary Cross-Culturally?” In Thinking Through Cultures: Expeditions in Cultural Psychology. Cambridge: Harvard University Press, 1991.
Tervalon, Melanie and Jann Murray-Garcia. “Cultural Humility versus Cultural Competence: A Critical Distinction in Defining Physician Training Outcomes in Multicultural Education.” Journal of Health Care for the Poor and Underserved 9(2) (1998): 117–125.
Veatch, Robert. “Ethical Consensus Formation in Clinical Cases.” In Consensus Formation in Healthcare Ethics. Edited by Henk A.M.J. ten Have and Hans-Martin Sass, 17–34. Dordrecht: Kluwer Academic Publishers, 1998.
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Vaught, W. A Moral Framework for Multicultural Education in Healthcare. Theor Med Bioeth 24, 301–328 (2003). https://doi.org/10.1023/A:1026096920403
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DOI: https://doi.org/10.1023/A:1026096920403