Vulnerability in the clinic: case study of a transcultural consultation
- PMID: 27343284
- DOI: 10.1136/medethics-2015-103337
Vulnerability in the clinic: case study of a transcultural consultation
Abstract
Discrimination and inequalities in healthcare can be experienced by many patients due to many characteristics ranging from the obviously visible to the more subtly noticeable, such as race and ethnicity, legal status, social class, linguistic fluency, health literacy, age, gender and weight. Discrimination can take a number of forms including overt racist statement, stereotyping or explicit and implicit attitudes and biases. This paper presents the case study of a complex transcultural clinical encounter between the mother of a young infant in a highly vulnerable social situation and a hospital healthcare team. In this clinical setting, both parties experienced difficulties, generating explicit and implicit negative attitudes that heightened into reciprocal mistrust, conflict and distress. The different factors influencing their conscious and unconscious biases will be analysed and discussed to offer understanding of the complicated nature of human interactions when faced with vulnerability in clinical practice. This case vignette also illustrates how, even in institutions with long-standing experience and many internal resources to address diversity and vulnerability, cultural competence remains a constant challenge.
Keywords: Clinical Ethics; Cultural Pluralism; Decision-making; Minorities; Patient perspective.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Similar articles
-
Implicit bias in healthcare professionals: a systematic review.BMC Med Ethics. 2017 Mar 1;18(1):19. doi: 10.1186/s12910-017-0179-8. BMC Med Ethics. 2017. PMID: 28249596 Free PMC article. Review.
-
Non-conscious bias in medical decision making: what can be done to reduce it?Med Educ. 2011 Aug;45(8):768-76. doi: 10.1111/j.1365-2923.2011.04026.x. Med Educ. 2011. PMID: 21752073
-
Under the radar: how unexamined biases in decision-making processes in clinical interactions can contribute to health care disparities.Am J Public Health. 2012 May;102(5):945-52. doi: 10.2105/AJPH.2011.300601. Epub 2012 Mar 15. Am J Public Health. 2012. PMID: 22420809 Free PMC article.
-
Physicians and implicit bias: how doctors may unwittingly perpetuate health care disparities.J Gen Intern Med. 2013 Nov;28(11):1504-10. doi: 10.1007/s11606-013-2441-1. Epub 2013 Apr 11. J Gen Intern Med. 2013. PMID: 23576243 Free PMC article. Review.
-
Unconscious race and social class bias among acute care surgical clinicians and clinical treatment decisions.JAMA Surg. 2015 May;150(5):457-64. doi: 10.1001/jamasurg.2014.4038. JAMA Surg. 2015. PMID: 25786199
Cited by 2 articles
-
The relevance of clinical ethnography: reflections on 10 years of a cultural consultation service.BMC Health Serv Res. 2018 Jan 11;18(1):19. doi: 10.1186/s12913-017-2823-x. BMC Health Serv Res. 2018. PMID: 29325569 Free PMC article.
-
Implicit bias in healthcare professionals: a systematic review.BMC Med Ethics. 2017 Mar 1;18(1):19. doi: 10.1186/s12910-017-0179-8. BMC Med Ethics. 2017. PMID: 28249596 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
-
Full Text Sources
-
Medical