Palliative care in a multicultural society: a challenge for western ethics

Abstract

Objective: This paper examines the notion of truth telling and its place in palliative care nursing with a particular focus on nursing people from minority cultures. Setting: The setting is palliative care nursing. Subjects: The subjects are patients receiving palliative nursing care particularly those from minority cultures. Primary argument: Australia is a multicultural society yet its dominant ethical paradigm is firmly placed in the western philosophical tradition. The fundamental concept that western ethics is based on is that of autonomy which implies that the individual is a free agent able to make their own decisions including accepting or rejecting medical treatments. These decisions are based on the individual’s right to be informed about all treatment options. From this position of the autonomous subject other ethical principles have their genesis. Nurses’ ethical behaviour is guided to some extent by ethical principals including beneficence, non‑maleficence and truth telling. The major contention, drawn from literature is that truth telling may be an inadequate ethical principle when working with people from minority cultures. Conclusion: This paper argues that the western ethical concepts of autonomy and truth-telling in the practice domain of palliative care nursing may not be appropriate for different cultural groups and that this may become a source of ethical dilemmas and a challenge for western ethics. The paper concludes with an option for nurses working in multicultural societies that accommodates differing cultural perspectives while not compromising the ethical principle of truth-telling.