NEGOTIATING CROSS CULTURAL ISSUES

NEGOTIATING CROSS CULTURAL ISSUES

by Matt Stone QHCusa 2010

Our purpose of discussion is to describe “Negotiation Efforts of Cross-Cultural Issues” of informed attitudes and preferences around end-of-life care, such as, informed consent, life support, advance directives, communication styles, and decision making. In support, view of significant findings about challenges to ensuring those patients or their surrogates can understand their rights and that their consent is truly informed. This is important because, as administrators, awareness of legal and ethical implications is a key element to promote and support proposed challenges dealing with how to prevent cultural misunderstandings or discrimination, and address problems when they arise.

Cross-Cultural Issues around end-of-life care is crucial and significant for providers to foster informed attitudes and preferences, for instance, informed consent, life support, advance directives, communication styles, and decision making. Kagawa (2001) describes a foundation of Cultural Fundamentals as, “cultural differences contributes in how individuals shape and make meaning out of illness, suffering, and dying, and thus, different backgrounds are becoming more common in these areas ” Further, relationship to end of life stages, cultural differences in attitudes relates to telling the truth, life-prolonging, decision-making and collaboration styles and techniques (Kagawa et al. 2001).

Although, our approach is sensitive to end of life stages, it is also built upon skilled collaborative and communication techniques. Together, Administrators communication styles promoting cross-cultural care, strategies in decision making and advance directives is built upon how our physicians, patient, and family members can collaborate to promote cross cultural understanding which aid in how we navigate among differing cultural beliefs, values, and practices, says, Kagawa (2001). For instance, Borkowski (2010) Stone (2010) cites, Interpersonal Skills, and Strategic Communication are an intentional process of presenting ideas in a clear, concise, and persuasive way. Communication can flow upward, downward, horizontally and diagonally (Borkowski et al. 2010).

For instance, there are five components of a strategic communication plan to promote collaboration, “Outcome: Specific result an Individual’s wants to achieve, Context: Importance of organizational communication, Message: Key information staff needs to know, and finally, Tactical Reinforcement: Tactics or methods used to reinforce our message for quality care (Studer, 2008). This leads us to Techniques for Negotiating Issues Influenced by culture that are important in End-of-Life Care, Informed consent, life support, and challenges to ensure patients and surrogates understand their rights and that their consent is truly informed.

One challenges to consider, Truth Telling, and possible consequences of ignoring current issues, says, Kagawa (2001), “Anger, mistrust, or removal of our patient from care if our care team insists on informing our patient against wishes of family members, and Hopelessness of our patient if he or she misunderstands reasons for telling him or her directly. Another issue and possible consequences to consider, Hospice Care, reduced use of hospice services leading to decreased quality of end-of-life care” (Kagawa, 2001). Kagawa (2001) cites techniques and strategies to address this issue are to, “Emphasize hospice as an assistance to families but not as a replacement: “When families are taking care of their family member at home, hospice can help them do that” (Kagawa, 2001).

When administrators are faces against Legal, ethical repercussion, and need assistance to prevent cultural misunderstandings or discrimination, administrators have available to them various consortiums. For instance, a bio-Ethics committee. Bio-Ethics committee is a multidisciplinary committee serving HCO as a resource to patients at all levels. Bio-Ethics committee is charged with committee functions, such as, policy and procedure development, in support, education on ethical concepts and issues concerning its members, organizational staff, and to their community. Further, Bio-Ethics committee serves as consultative role to assist patients and their families acting as an advocate ensuring clarification of issues regarding collaborative and decision making capacity, informed consent and advanced directives (Pozgar, 2010).

In summary, Negotiation Efforts of Cross-Cultural Issues of informed attitudes and preferences around end-of-life care, such as, informed consent, life support, advance directives, communication styles, and decision making, fosters a collaborative effort equally shared by all parties involved. Thus, disciplines regarding our five components of a strategic communication plan to promote collaboration efforts. Context: Importance of organizational communication, Message: Key information staff needs to know and finally Tactical Reinforcement: Tactics or methods used to reinforce our message to consumers for quality care, respectfully, (Studer, 2008).