Her husband, Thomas was banking professional who was going through a period of serious financial crisis owing to the economic recession and resulting salary cuts. I came to know from Maya, her husband and his sister that she dearly wanted the baby to be born. As I could involve her into an intimate personal conversation, she told me that her parents were eagerly awaiting the birth of her second child as there was a belief in her family that the second child of every girl in the family would be a girl child and she would be the cause of prosperity for the family (because their community had a matrilineal family system). In Maya’s current pregnancy also, the medical tests had showed that she was carrying a girl child. The family legend was that if you do not let the second child to be born, the whole family would be cursed. Her gynecologist had advised that if she wanted, she could retain her pregnancy but the child would live only for a very short period of time and that too in misery. This was a situation that Thomas wanted to avoid at any cost and hence he was trying to convince her to undergo an abortion. And he also did not have any faith in her family legend. But Maya was not totally uninfluenced by the family traditions and her father adamantly believed in that. And Maya and her parents were against abortion in their beliefs. Thomas had called her parents in Sri Lanka over phone to tell them that she needed to terminate the pregnancy but after that her father had refused to attend her or her husband’s calls. He had also wrote her a letter telling that destroying the child would bring in a curse on the family and will affect even the generations to come. He also wrote that she should keep her trust and leave the rest to God. After listening to Maya and all who were concerned (including Thomas, his sister Emma, Maya’s friend Lisa and Maya’s mother over phone), I was faced with an ethical dilemma- whether to support Maya in her decision or to try to convince her to undergo an abortion. I had heard that tumors in children have a better chance of getting cured than in adults but I had no scientific data available on that. So I started collecting data from books, scientific publications and authentic websites. The conclusion that I arrived at was that many tumors in children have a chance of getting cured and also I came to know that “over half of the children diagnosed with brain tumors will live more than five years” (Rosenbaum, Dolinger and Rosenbaum, 2008, p.549). But still there can be no blanket assurance that the child would survive. But the more important aspect of the problem before me was that Maya and her family belonged to a culture rooted in religiosity and family bonding, while her husband and his family hailed from the Western culture, which is less religious and more individualistic (White, 2005, p.206-207). Hence the ethical dilemma before me was a product of the interaction between two different cultures and hence it demanded certain amount of cultural competence from me as a nursing practitioner. Andrews and Boyle (2008) have drawn attention to this aspect by observing that “[e]quity, fairness, and meaningfulness in caring are fully realized by cultural
Culturally Competent Ethical Decision Making Name of of Teacher Subject Date Culturally Competent Ethical Decision Making Step-1- Description of the issue The case of Maya, who was a patient under my care in the psychiatric ward in Southern Health, was a case which presented before me the greatest culturally defined ethical dilemma I ever experienced in my profession so far…
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