________________________________________________________________ Cultural Humility in Healthcare
Healthcare professionals need to be self-aware and realize that patients react positively to healthcare professionals who display personal warmth, authenticity, credibility, and respect and who strive for human connectedness. Practicing with cultural humility provides the following: a promising alternative to cultural competence … as it makes explicit the interaction between the institution and the individual and the presence of systemic power imbalances. It further calls upon practitio- ners to confront imbalances rather than just acknowledge they exist. Cultural humility challenges us to ask difficult questions instead of reducing our clients to a set of norms we have learned in a training or course about “difference.” We believe that asking critical questions … challenge our own practice as well as our organizations and institutions and will provide a deeper well from which to approach individual and community change and effective long-term practice (Brown et al., 2021). INSTITUTIONAL AND SOCIETAL ACCOUNTABLE: SOCIAL JUSTICE Healthcare delivery takes place within and reflects the larger culture. Although healthcare delivery can certainly aid in the wellness of patients, it does not occur in a vacuum. Wellness cannot be achieved when social injustice is present. Traditionally some healthcare professionals may consider issues of social justice outside the realm of their practice; however, if social justice is relegated to a select few, oppression will flourish and efforts to heal communities will be blocked. The healthcare professional practicing within a social justice framework would not locate the problem within the individual but would look to the environmental factors that contribute to the actions and reactions of the individual (Sue & Sue, 2021). Social justice is the view that everyone deserves equal eco- nomic, political, and social rights and opportunities. Social justice depends on economic justice. Proponents of social justice explain that there must be fair and compassionate dis- tribution of economic growth. Social justice requires that all persons be provided with access to what is good for the person and in associations with others. According to the principles of social justice, all people have a personal responsibility to work with others to design and continually perfect societal institutions for both personal and social development (San Diego Foundation, 2024). Although there are variations among the definitions of social justice, there are three factors that are part of all definitions. These are (San Diego Foundation, 2024): • Equal rights. • qual opportunity. • Equal treatment. In other words, social justice mandates equal rights and equal opportunities for everyone.
It is imperative that healthcare professionals ask themselves key questions that facilitate the acquisition of social justice. Examples of such questions include the following: • How do my behaviors within patient interactions actively challenge any power imbalances and involve communities experiencing marginalization? • How, as healthcare professionals, do we address inequalities? • How am I extending my responsibility beyond individual patients? • How am I advocating for policy and practice changes at institutional, community, state, and national levels? • What institutional structures are in place that address inequalities? • What training and professional development activities are offered at our institution or in our community that address inequalities? • How ca:n we engage our community to make sure its voice is heard in this work? (Adapted and updated from Fisher-Borne et al., 2015, p. 176). These types of questions can provide a starting point for healthcare professionals to address social injustices. Healthcare professionals can use their positions to advocate for changes in society to promote social justice. Working toward social justice, patients are empowered and can help create an envi- ronment in which equal rights, treatment, and opportunity are available to all. DIFFERENCES BETWEEN MULTICULTURAL COMPETENCY AND CULTURAL HUMILITY Cultural humility is a conceptual framework that was first developed and utilized in the field of medicine and nursing in the 1990s. Since that time, it has become more widely applied to all helping professions. The framework is intended to address some of the shortcomings within the cultural competency and multicultural counseling frameworks. The approach of cultural humility differs from the multicultural competency approach in that it recognizes that knowledge of different cultural backgrounds is not sufficient to develop an effective patient/healthcare professional relationship with each individual. The cultural competency and multicultural counseling frameworks are most often criticized for creating a model that serves to “other” ethnic, racial, and various minor- ity groups (Carten, 2016, p. xlii) while not acknowledging “Whiteness” as an identity and as a culture. “Othering” is the term used for the “biased assumptions about populations viewed as ‘the other’ at various times in the country’s history,” as well as in the present (Carten, 2016, p. xlii).
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