The Foundations of Pluralism and Tolerance and the Incoherence of Cultural Relativism

1
The Foundations of Pluralism and Tolerance and
the Incoherence of Cultural Relativism
2
Professional Boundaries

• The defining lines which separate therapeutic
  behavior of a registered nurse from behavior
  which, well intentioned or not, could reduce the
  benefit of nursing care to patients, clients,
  families, and communities
• Straightforward in some instances, but a review
  of literature reveals that determining such
  boundaries is a very complex issue (CRNNS, Prof.
  Boundaries and Expectations for Nurse-Client
  Relationships, 2002)

3
Can Nurses Discuss Religion with Others?

• Nurses must be sensitive to the inherent power
  differentials between care providers and those
  receiving care. They do not misuse that power to
  influence decision making (CNA Code of Ethics,
  11)
• Proselytizing to a sick person is certainly out,
  but does this mean all discussion of ones
  religious or spiritual views is out of bounds?

4
Can Nurses Avoid Discussing their own Spiritual/
Religious Views?

• Nurses build trustworthy relationships as the
  foundation of meaningful communication,
  recognizing that building these relationships
  involves a conscious effort (8)
• Nurses, to the extent possible provide persons
  in their care with the information they need to
  make informed decisions related to their health
  and well-being (11)
• Health a state of complete physical, mental
  (spiritual) and social well-being, not merely the
  absence of disease (13)

5
Spirituality and Care

• In health-care decision making, in treatment and
  in care, nurses work with persons receiving care,
  including families, groups, populations and
  communities, to take into account their unique
  values, customs and spiritual beliefs (13)

6
Personal Values and Care

• If nursing care is requested that is in conflict
  with the nurses moral beliefs and values, but in
  keeping with professional practice, the nurse
  provides safe, compassionate, competent and
  ethical care until alternative arrangements are
  in place to meet the persons needs or desires
  (19)

7
Self-Disclosure

• The sharing of personal information to improve
  understanding between persons
• A nurse may choose to use it when he or she
  determines that the information will be
  therapeutically benefit the client
• Must always be provided only for the clients
  welfare
• (CRNNS, Prof. Boundaries and Expectations for
  Nurse-Client Relationships, 2002)

8
Code of Ethics for Registered Nurses

• Culturally Sensitive Care p. 8 (1,2,3), p. 10
  (3)
• Self-Disclosure p. 8 (2,3)
• Limits on self-disclosure and culturally
  sensitive care p. 17 (1,2), p. 11 (5), p. 19
  (7), p. 12 (8)
• Ethical Thinking pp. 4-7, pp. 36-38

9
Different Views on the Moral Foundations of
Tolerance

• Cultural Relativists believe we must be sensitive
  to the values and choices of other people b/c
  there is no ultimate way to judge the values of
  cultures different from ones own
• Moral Objectivists believe we must be sensitive
  to the values and choices of other people b/c
  there are absolute moral standards (eg. human
  rights) for doing so that transcend different
  cultures

10
Cultural Relativism

• The ethical theory that values are only rooted in
  and cannot be separated from the beliefs and
  behaviors of particular cultures
• Hence, what is wrong in one culture may not be so
  in another
• Serious objections to this view (What about the
  Nazis? What about Human Rights? Cultural Diffs
  Argument fails, etc)

11
Moral Objectivism

• The belief that moral values can be objectively
  true independent of individual, subjective
  feelings or societal norms
• Major objection But what about all the
  differences between cultures?
• Response There are many areas of agreement (eg.
  Golden Rule)