Medical ethics in cross-cultural and multi-cultural perspectives

Abstract

Recent concern with medical ethics is confined almost entirely to Western nations and Western medical systems, and is inspired primarily by contemporary technological developments. Little attention has been paid in past research to the logical necessity that an effective ethics must assign priorities between coexisting values in situations where difficult choices must be made, nor has empirical research been carried out to determine whether the choices that are made reflect a consistent ordering of values in supposedly homogeneous Western societies. Medical ethics have received little attention in comparative studies of medical systems, or in the cross-cultural transfer of medical knowledge and technology, where they may have major policy implications, as, for example, in family planning programs. Current ethical concerns in the West are dominated by the implications of new medical technology which may have little immediate application to non-Western countries, but such ethical questions as the allocation of scarce medical resources and the conflicts of obligations of healers to patients and other members of society must exist in all societies. The processes by which patients and practitioners are socialized with regard to medical ethics and the formal and informal mechanisms for inducing conformity to ethical standards are poorly described in studies of non-Western medical systems. Other than the question of religious differences, studies of Western medical ethics have not considered cultural differences, and simply ignore the pluralism which exists in healing systems of Western societies. Studies of the ethical implications of medical pluralism in non-Western societies have yet to be made. Aside from their inherent interest and potential importance for cross-cultural medical policy, comparative studies of medical ethics in cross-and multi-cultural context should yield important clues as to the structure of the moral order in complex and changing traditional socieities. Case studies of medical ethical problems, observation of the processes of medical decision-making, descriptive ethnography of formal and informal methods of inducing conformity with medical ethical values, and questionnaires tailored to the particular culture should be particularly helpful in studying these phenomena.