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Culturally Competent Bioethics: Analysis of a Case Study


This paper discusses the Saudi Arabian case by Abdallah Adlan and Henk ten Have, published in a 2012 issue of the Journal of Bioethical Inquiry, regarding a congenitally disabled child enrolled in a research project examining the genetics of her condition. During the course of the study, her father was found not to be genetically related, and the case discussed the dilemma between disclosing to the family all findings as promised in consent documents or withholding paternity information because of the likely severe social repercussions. Using Adlan and ten Have’s example, this paper proposes a framework to consider cases outside of the conventional bioethics frame of reference, splitting the bioethical task into three elements: understanding the problem from the patient’s and the clinician’s perspective and then engaging in dialogue to decide what to do next. The process of dialogue between affected parties is vital. Presuming that there is a common morality undermines the effectiveness of the dialogue needed to find a resolution.

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  1. Adlan, A.A., and H.A.M.J. ten Have. 2012. The dilemma of revealing sensitive information on paternity status in Arabian social and cultural contexts. Journal of Bioethical Inquiry 9(4): 403–409.

    Article  PubMed  Google Scholar 

  2. Ashby, M.A., and L.E. Rich. 2012. Cases and culture: The benefits and risks of narrating “life as lived.” Journal of Bioethical Inquiry 9(4): 371–376.

    Article  PubMed  Google Scholar 

  3. Beauchamp, T.L., and J.F. Childress. 2013. Principles of biomedical ethics, 7th ed. New York: Oxford University Press.

    Google Scholar 

  4. Betancourt, J.R., A.R. Green, and J.E. Carrillo. 2002. Cultural competence in health care: Emerging frameworks and practical approaches. The Commonwealth Fund, October.

  5. Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada, and Social Sciences and Humanities Research Council of Canada. 2010. Tri-council policy statement: Ethical conduct for research involving humans. Ottawa: Interagency Secretariat on Research Ethics.

  6. Churchill, L.R., J.B. Fanning, and D. Schenck. 2013. What patients teach: The everyday ethics of health care. Oxford: Oxford University Press.

  7. Harman, G. 2007. Is moral relativism correct? Yes. In Taking sides: Clashing views on moral issues, 14th ed. expanded, edited by S. Satris, 4. Dubuque, IA: Dushkin Publishing Group.

  8. Hofstede, G. 2010. Cultures and organizations: Software of the mind: Intercultural cooperation and its importance for survival, 3rd ed. New York: McGraw-Hill.

    Google Scholar 

  9. Komesaroff, P.A. 2012. Cross-cultural issues in ethics: Context is everything. Journal of Bioethical Inquiry 9(4): 417–418.

    Article  PubMed  Google Scholar 

  10. Lingis, A. 2012. The rationality of values. Journal of Bioethical Inquiry 9(4): 411–412.

    Article  PubMed  Google Scholar 

  11. Multicultural Mental Health in Australia. 2002. Cultural awareness tool: Understanding cultural diversity in mental health. Parramatta, BC: West Australian Transcultural Mental Health Centre, The Royal Australian College of General Practitioners WA Research Unit, Commonwealth Department of Health and Ageing, and Multicultural Mental Health Australia.

  12. National Health and Medical Research Council. 2003. Values and ethics: Guidelines for ethical conduct in Aboriginal and Torres Strait Islander health research. Canberra: Commonwealth of Australia.

  13. Parekh, B. 1996. Minority practices and principles of toleration. International Migration Review 30(1): 251–284.

    Article  Google Scholar 

  14. Pūtaiora Writing Group. 2010. Te ara tika: Guidelines for Māori research ethics: A framework for researchers and ethics committee members. Auckland: Health Research Council of New Zealand.

  15. Taylor, J.S. 2003. Confronting “culture” in medicine’s “culture of no culture.” Academic Medicine 78(6): 555–559.

    Article  PubMed  Google Scholar 

  16. Tsai, D. 2012. Reflections from Taiwan on unsought truth-telling: Comparison with lessons from Saudi Arabia. Journal of Bioethical Inquiry 9(4): 415–416.

    Article  PubMed  Google Scholar 

  17. Ujewe, S.J. 2012. Ought-onomy and African health care: Beyond the universal claims of autonomy in bioethics. Thesis, Master of Health Sciences, University of Otago.

    Google Scholar 

  18. Women on Waves. No date. How to do an abortion with pills (misoprostol, cytotec)? Accessed July 15, 2014.

  19. Zabidi-Hussin, Z.A.M.H. 2012. Does nondisclosure of genetic paternity status constitute a breach of ethics? Journal of Bioethical Inquiry 9(4): 413–414.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Ben Gray.

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Gray, B. Culturally Competent Bioethics: Analysis of a Case Study. Bioethical Inquiry 12, 361–367 (2015).

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  • Cultural competence
  • Ethics clinical
  • Ethical relativism
  • Common morality