Am J Obstet Gynecol. 2013 Oct 28. pii: S0002-9378(13)01963-7. doi: 10.1016/j.ajog.2013.10.876. [Epub ahead of print]

Teaching Ethics: When Respect for Autonomy, and Cultural Sensitivity Collide.

Minkoff H.

Source

Department of Obstetrics and Gynecology, Maimonides Medical Center, SUNY Downstate. Electronic address: hminkoff@maimonidesmed.org.

Abstract

Respect for autonomy is a key ethical principle. However, in some cultures other moral domains such as community (emphasizing the importance of family roles) and sanctity (emphasizing the sacred, and the spiritual side of human nature) hold equal value. Thus an American physician may sometimes perceive a conflict between their desire to practice ethically and their wish to be sensitive to the mores of other cultures. For example, a woman may appear to be making what the physician thinks is a bad clinical choice because her spouse is speaking on her behalf. That physician may find it difficult to reconcile their sense that the patient had not freely exercised her autonomy with their desire to be culturally sensitive. In this article the means by which a physician can reconcile their respect for other cultures with their respect for autonomy is explored. The question of whether physicians must always defer to patients' requests solely because they are couched in the language of cultural sensitivity is also addressed.