Cultural Safety in Aotearoa New Zealand

Introduction

Caring is an ethical activity with a deep moral commitment that relies on a trusting relationship (Holstein, 2001 ). Health professionals are expected to be caring, skilful, and knowledgeable providers of appropriate and effective care to vulnerable people. Through universal services they are expected to meet the needs of both individual clients and broader communities, which are activities requiring sensitivity and responsiveness. In an increasingly complex globalised world, ethical reflection is required so that practitioners can recognise plurality: in illness explanations; in treatment systems; in the varying roles of family/whānau or community in decision making; and in the range of values around interventions and outcomes. To work effectively in multiple contexts, practitioners must be able to morally locate their practice in both historical legacies of their institutional world and the diversifying community environment. This chapter examines the frameworks that health professionals can use for crosscultural interactions. I then explore how they can select the most appropriate one depending on the person or group being cared for.

Ethics

Ethics is a part of all our actions as humans and as nurses. Ethics is about how nurses talk to their clients, how they respond to difference and how they make decisions. The word originates from the Greek word ‘ethos’, which refers to habits and character. Ethics can be seen in all religions, philosophies and cultures, even in those language groups that do not use the term. In the context of health, having an ethical framework provides a shared means of collectively and systematically examining varying viewpoints related to moral questions of right and wrong. Ethics is also a generic term used to refer to the ways people can think about, understand and examine how best to live a ‘moral life’ (Beauchamp & Childress, 2001 ). Ethics involves critical thinking and asking questions to highlight the appropriate course of action. It requires health professionals to consider and reconsider the taken for granted (Beauchamp & Childress, 1983 ). When working with people, it is inevitable that health professionals will confront an ‘ethical problem’ – a situation that raises questions that cannot be answered with a simple rule or fact.