Ethical Decision-Making and Cultural Competence

It is worth noting that nursing ethics presupposes a set of ethical norms that drive the conduct of employees when performing their professional duties. In their practice, specialists should be guided by multiple principles and skills including cultural competence, which is attributed to increasing importance in the world of high cultural diversity (Butts & Rich, 2015). This principle assumes that medical personnel should respect the personality of each patient and his or her decisions regarding health.

Such aspects of care as confidentiality, respect for culture and religion, spiritual beliefs of the patient, informed consent to medical intervention, and a person’s independent decision-making should always be observed by healthcare providers. The purpose of this paper is to describe an ethical scenario, which has occurred in my professional experience and discuss its implications.

Ethical Scenario

Several years ago, one family brought their daughter who was suffering from seizures. The family members were American citizens; however, they belonged to a small ethnical group that united in a commune, and only the representatives of this culture resided in it. When the family turned to the unit for help, and a nurse intended to examine the girl, the father of the family became aggressive and said that they would leave the facility if the specialist would continue trying to touch his daughter. Initially, the staff was unaware of the fact that this family had unique cultural beliefs, and it was forbidden for males to have any form of physical contact with females. Therefore, the staff exhibited cultural incompetence by ignoring the need to investigate the family’s background before performing any manipulations.

Techniques Used to Resolve the Conflict

Because the girl’s condition was deteriorating, it was essential to build effective communication as soon as possible. The girl’s mother was referred to me so that I could interview her on the practices that would be permissible for their family. I tried to establish a secure and shame-free environment so that we could discuss all the health-related issues and the cultural practices that this family would approve. In the course of our discussion, it was decided that the girl would be inspected by a female nurse and would be referred to a female doctor, and the father of the family will be present during all manipulations so that he would permit all the required actions. Therefore, the technique that helped to resolve the conflict was an effective communication strategy with due respect to cultural differences.

Ethical Principles and Cultural Competence

The main ethical principles that were addressed in this complex setting were the rule of beneficence to ensure the girl would receive the best of care, respect for autonomy so that parents would execute independent decision-making related to the condition of their child, and the principle of non-maleficence (Butts & Rich, 2015). In terms of the latter principle, the cultural beliefs of the family implied a conviction that seizures were a primary step for a child to develop clairvoyance skills (this belief was widespread among their culture). However, they decided to turn to the facility since their daughter stopped responding to them.

Therefore, the goal of the healthcare team was to explain comprehensively the critically of the child’s condition and the need to take immediate interventions to avoid irreversible consequences to the health of the underage patient. Therefore, the main competence that the entire team had to exhibit was cultural sensitivity. Through this competence, the nursing team was able to do both – provide care to the underage patient and respect the cultural beliefs of the family.


Thus, it can be concluded that ethical principles and cultural competence are interconnected. The case discussed evidence that being culturally incompetent or ignorant might result in severe consequences for the patient’s health (Stanhope & Lancaster, 2014). Therefore, all healthcare specialists need to exhibit respect and understanding of the diversity of values and practices while keeping the health-related goals as their top priority.


Butts, J. B., & Rich, K. L. (2015). Nursing ethics (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Stanhope, M., & Lancaster, J. (2014). Public health nursing: Population-centered health care in the community (8th ed.). New York, NY: Elsevier.