Introduction
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The impact of culture on family involvement
- Clinicians should be mindful of an individual’s cultural background.
- Different cultures place greater / lesser value on the importance of family when a loved one is experiencing illness.
- Western medicine is based on an individualistic ‘patient as priority' approach which is ingrained in law, ethics, and tradition.
- However, some other cultures regard the family-doctor-patient triad as the norm, and a family-centered approach may be preferred.
Collectivist cultures
- In many collectivist cultures, such in China, Japan, Korea, and Pakistan, the family are more likely to make important decisions about their loved one’s treatment and care.
- For example, in China, the family member is often seen as a bridge between the patient and doctor and may take on the decision-making role for the patient on behalf of the interests of the whole family.16
Indigenous Australians
- For many individuals identifying as Aboriginal or Torres Strait Islander, health is a matter of the wellbeing of the community and extended family.
- Due to family kinship structures and relationships, family are usually involved in medical decisions with the patient. 17
Balancing patient culture with Australian law
Clinicians should be aware of, and sympathetic to, the different cultural approaches to family involvement in cancer care, whilst simultaneously upholding principles of patient autonomy (privacy, communication, participation) required under Australian law.
Whilst there may be different norms and practices within some cultures, individual differences and variability within cultures also exist.
It remains of central importance that clinicians check in with their patients about their preferences for the extent of family involvement irrespective of their cultural background.
Learn more
Several sections of this program will be helpful for navigating situations that may arise due to cultural differences:
- Guideline 7 provides guidance on dealing with a large number of family members attending the consultation.
- Guideline 9 provides guidance on managing family requests for nondisclosure of information to the patient.
- Guideline 10 addresses the use of interpreters, which can be important when communicating with patients and family members from CALD groups.
Additional training on communicating with CALD groups is available: For further guidance on communicating with CALD groups, you may like to refer to this training program for oncology health professionals that is available on eviQ. https://edumodules.eviq.org.au/Resources/CALD/Intro/EG../index.html
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