Cultural Fault Lines in Healthcare Cultural Fault Lines in Healthcare Reflections on Cultural Competency Michael C. Brannigan LEXINGTONBOOKS Lanham•Boulder•NewYork•Toronto•Plymouth,UK PublishedbyLexingtonBooks AwhollyownedsubsidiaryofTheRowman&LittlefieldPublishingGroup,Inc. 4501ForbesBoulevard,Suite200,Lanham,Maryland20706 www.lexingtonbooks.com EstoverRoad,PlymouthPL67PY,UnitedKingdom Copyright©2012byLexingtonBooks Allrightsreserved.Nopartofthisbookmaybereproducedinanyformorbyany electronicormechanicalmeans,includinginformationstorageandretrievalsystems, withoutwrittenpermissionfromthepublisher,exceptbyareviewerwhomayquote passagesinareview. BritishLibraryCataloguinginPublicationInformationAvailable LibraryofCongressCataloging-in-PublicationData Brannigan,MichaelC.,1948– Culturalfaultlinesinhealthcare:reflectionsonculturalcompetency/MichaelC.Brannigan. p.cm. Includesbibliographicalreferencesandindex. ISBN978-0-7391-4966-9(hardback)—ISBN978-0-7391-4967-6(paper)—ISBN978-0-7391- 4968-3(ebook) 1.Transculturalmedicalcare—UnitedStates.2.Culturalcompetence—UnitedStates.I.Title. RA418.5.T73B732012 362.1—dc23 2011045096 ThepaperusedinthispublicationmeetstheminimumrequirementsofAmerican NationalStandardforInformationSciencesPermanenceofPaperforPrintedLibrary Materials,ANSI/NISOZ39.48-1992. PrintedintheUnitedStatesofAmerica Tomydearfriendandcolleague Dr.JohnBalint, physician,teacher,scholar,andhealer whoembodiesgenuinepresence throughouthiscompetentcaringandcompassion Contents Acknowledgments ix Introduction xi 1 WhenWorldviewsCollide 1 2 FromFaultLinestoCulturalCompetency 15 3 CulturalDiscourseandItsHurdles 33 4 OnthePathtoPresence 53 5 CultivatingPresenceWhenThereIsDistrust 61 Appendix:PrinciplesofHealthcareEthics 77 Bibliography 87 Index 93 AbouttheAuthor 103 vii