Ethical Dilemmas and Cultural diversity

The aspect of globalization has resulted to ethical dilemmas among nurses based on cultural differences (Schim and Doorenbos, 2010). A deep harmony in the world may result from enlightened globalization and the opposite occurs with unilateral globalization. This assignment will explore on cultural ethical dilemmas in terms of social justice, the law, competency and respect. Today, nurses and other health professionals may originate from varying cultures, train in a different country and practice with diverse patients and colleagues (Suphanchaimat, 2015). This poses the practice at risk of a clash between culture and ethical rules of conduct, which calls for ethical decision making.

Ethical Dilemma

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During practice, I met Spanish speaking migrant at her late thirties, Mrs. M. She had been treated earlier in a migrant health center. However, condition required further expertise that was not in the migrant health clinic. During my routine she presented he health records and was shaking. The procedure required was expensive and she had no insurance cover. Although I recognized that the client required fibroid removal, I faced ethical challenges. The first challenge was to involve the patient in health decision. The second ethical challenge was to analyze the patient’s financial arrangements or the provision of uncompensated care which she could not afford. 

Perception of the Dilemma

I found Mrs. M at a precarious condition due to fear. The great challenge in delivering care was language issue as her English was poor. This led me to compromise the patient’s autonomy by excluding her in decision making process. Mrs. M although frightened expected the health system to provide quality care irrespective of her immigrant status. However, as a professional I was bound by law not to provide care to undocumented immigrate unless during emergencies, caring for children or adolescents under 18 years. 

Conflicting Values and Belief System

The conflicting values and belief system were that as undocumented immigrant, Mrs. M was not entitled for Medicaid. The case questioned the aspect of beneficence and justice; including my responsibility as a nurse, limits and prospects for charity care, and decision making to allocate resource to undocumented individual. However, the Ethics Manual of the American College of Physicians expects health professionals to do their best in ensuring all patients receives care. The aspect of justice illustrates the delivery of care to all person irrespective of their category or class, hence it was my duty to act to the best interest of uninsured individual. 

Missing Elements

From a nurses’ lens, Mrs. M status as an undocumented Spanish speaking woman should not have a bearing on whether the client should receive or not receive treatment. Although as a health professional, Mrs. M deserves treatment, from a government lens, her status means that she is unqualified for majority of care treatment in Medicaid insurance. Upon meeting Mrs. M, I was not aware of his undocumented status until later

Culturally Congruent Care

There are challenges linking cultural competency to a client outcome and their family. According to Campinha-Bacote (2002), cultural congruence is a process of effective interactions between patients and health professionals. One major aspect of cultural congruence is that it requires health professionals to continuously improve communication thus, it is an ongoing process. Cultural congruent comprises of cultural preservation, accommodation, and repatterning.

In conclusion, nurse faces varying magnitude of cultural diversity ethical dilemmas. The dilemmas occur as a clash between culture and ethical rules of conduct. An ethical–moral obligation is essential in solving the ethical problems. For example, the aspect of social justice in healthcare greatly conflicts the local policies and laws against vulnerable population. This can be solved by adopting a cultural congruence care.

Reference

Campinha-Bacote, J. (2002). The Process of Cultural Competence in the Delivery of Healthcare Services: A Model of Care. Journal of Transcultural Nursing13(3), 181-184.

Schim, S., & Doorenbos, A. (2010). A Three-Dimensional Model of Cultural Congruence: Framework for Intervention. Journal of Social Work in End-Of-Life & Palliative Care6(3-4), 256-270. doi: 10.1080/15524256.2010.529023Suphanchaimat, R., Kantamaturapoj, K., Putthasri, W., & Prakongsai, P. (2015). Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens. BMC Health Services Research15(1). doi: 10.1186/s12913-015-1065-z

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