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A Cross-Cultural Dialogue on Health Care Ethics

Edited by Harold Coward & Pinit Ratanakul
Subjects Ethnography, Philosophy, Ethics
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Paperback : 9780889203259, 288 pages, April 1999

Table of contents

Table of Contents for A Cross-Cultural Dialogue on Health Care Ethics, edited by Harold Coward and Pinit Ratanakul
1. Introduction | Harold Coward and Pinit Ratanakul
Part I: Culture, Health, and Illness
Part I, Introduction | Michael McDonald
2. Buddhism, Health, Disease, and Thai Culture | Pinit Ratanakul
3. Concepts of Health and Disease in Traditional Chinese Medicine | Edwin Hui
4. Discourses on Health: A Critical Perspective | Joan Anderson and Sheryl Reimer Kirkham
5. Expanding Notions of Culture for Cross-Cultural Ethics in Health and Medicine | Peter Stephenson
6. Health, Health Care, and Culture: Diverse Meanings, Shared Agendas | Michael McDonald
Part I, Conclusion | Harold Coward
Part II: Culture and Health Care Ethics
Part II, Introduction | Barry Hoffmaster
7. Buddhist Health Care Ethics | Pinit Ratanakul
8. Chinese Health Care Ethics | Edwin Hui
9. Secular Health Care Ethics | Barry Hoffmaster
Part II, Conclusion | Barry Hoffmaster
Part III: Ethical Issues in the Delivery of Health Care Services
Part III, Introduction | Michael Burgess
10. Pediatric Care: Judgments about Best Interests at the Onset of Life | Michael Burgess, Patricia Rodney, Harold Coward, Pinit Ratanakul, and Khannika Suwonnakote
11. Comparing the Participation of Native North American and Euro-North American Patients in Health Care Decisions | Edward Keyserlink
12. End-of-Life Decisions: Clinical Decisions About Dying and Perspectives on Life and Death | Michael Burgess, Peter Stephenson, Pinit Ratanakul, and Khannika Suwonnakote
Part III, Conclusion | Michael Burgess
Part IV: Health Policy: A Cross-Cultural Dialogue
Part IV, Introduction | Patricia Rodney
13. A Critical View of North American Health Policy | Arthur Blue, Edward Keyserlingk, Patricia Rodney, and Rosalie Starzomski
14. Threats from the Western Biomedical Paradigm: Implications for Chinese Herbology and Traditional Thai Medicine | Edwin Hui, Sumana, Tangkanasingh, and Harold Coward
15. Global Challenges: Ethical Implications of the Greening of Modern Western Medicine | Barry W. Glickman
Part IV, Conclusion | Joan Anderson and Patricia Rodney
16. Conclusion | Robert Florida
About the Editors
Subject Index
Contributors’ Bios
Joan M. Anderson is Professor of Nursing at the University of British Columbia School of Nursing. She received her PhD in sociology from the University of British Columbia in 1981. She works primarily in the area of culture and health, anti-racism in health care, and women and health. She is the author of a number of articles on various aspects of health care, culture, and women’s health.
Arthur W. Blue is a Professor Emeritus at Brandon University, a retired clinical psychologist, a former psychological advisor to Health Canada, and psychological consultant to Corrections Canada. He was the first president of the Native Psychological Association in Canada, the Society for the Advancement of Native Studies, and Chairman of the editorial board for The Canadian Journal of Native Studies. He has been involved with a number of international research projects including: Child of Two Soils, International grant to study the cross-over effect in North American Indian children, Tiyospaye Project, NIMH grant to study the effects of traditionality on health on the Rosebud Reservation. Alzheimer’s Study of North American Indians, NIH grant to examine the incidence of Alzheimer's in Indian communities. He is the author of a number of articles dealing with mental health and acculturative stress in Aboriginal peoples of North America.
Michael M. Burgess is a philosopher, specializing in bioethics. He currently holds a research chair in Biomedical Ethics at the University of British Columbia’s Centre for Applied Ethics, the department of Medical Genetics, and a clinical appointment to the B.C. Children’s Hospital. Following completion of his PhD at the University of Tennessee, he was on the Faculty of Medicine at the University of Calgary, and served as an ethics consultant to hospitals and a regional health care unit. His current research utilizes qualitative research methods to assess the effects of genetic technology on family relations and on society, specifically in the areas of Huntington disease and breast cancer. Other recent work is in cross-cultural health care ethics.
Harold Coward is Director of the Centre for Studies in Religion and Society and Professor of History at the University of Victoria. His main fields are comparative religion; psychology of religion; and environmental ethics. He serves as an Executive Member of the Board, Canadian Global Change Program. His wide variety of publications include Pluralism: Challenge to World Religions (1985), Population, Consumption and the Environment: Religious and Secular Responses (SUNY Press, 1995), and Life After Death in World Religions (Orbis, 1997).
Robert E. Florida is Professor of Religious Studies and Dean of Arts at Brandon University. His current research interests are in Buddhist ethics and health care ethics. He has recently served on the board of the Canadian Bioethics Society and has organized bioethics workshops for the community in Brandon, Manitoba.
Barry W. Glickman is a Professor in Biology and Director of the Centre for Environmental Health at the University of Victoria. He received his PhD in Molecular Genetics from the University of Leiden in 1972 and works primarily on the relationship between the environment and cancer with a particular interest in the origins of mutation. His research has included studies on the genetic effects of radiation, including both accident victims and Soviet cosmonauts, and the role of DNA repair in determining individual predisposition to cancer. He is an editor of Mutation Research and on the editorial board of Environmental and Molecular Mutagenesis.
Barry Hoffmaster is a Professor in the Departments of Philosophy and Family Medicine at the University of Western Ontario. From 1991 to 1996 he was the Director of the Westminster Institute for Ethics and Human Values in London, Ontario. He served as President of the Canadian Bioethics Society in 1994–95, and he has been a Fellow of The Hastings Center since 1995. He is a co-author of Ethical Issues in Family Medicine (Oxford University Press, 1986) and a co-editor of two collections of essays and one text in bioethics and one collection of essays in journalism ethics.
Edwin Hui is Associate Professor of Medical Ethics and Spiritual Theology and Associate Dean in charge of the Chinese Studies Program in Regent College, University of British Columbia, where he received his MD and PhD and theological training. He is a Research Associate of UBC’s Centre for Applied Ethics and Ethicist of the B.C. Cancer Agency and since 1995 Visiting Professor to the Department of Philosophy and Religion of Peking University. He is the founding editor of the Regent Chinese Journal, and his research interests include the interface between medicine and theology, and religion and culture. His recent publications include two edited volumes in ethics entitled Questions of Right and Wrong (1993) and Christian Character, Virtues and Bioethics (1996), and a volume in religious studies entitled Dialogue: Confucianism, Buddhism, Daoism and Christianity(1997).
Edward Keyserlingk is Associate Professor in the Department of Social Studies of Medicine and Director of the Biomedical Ethics Unit, Faculty of Medicine, McGill University. He is also Director of the Ethics and Law Teaching Program in the Faculty of Medicine and Clinical Ethicist at the Montreal General Hospital. He did his graduate studies in both ethics and law and received his PhD from McGill University in 1983. He works in both bioethics and health law with a particular interest in cross-cultural perspectives in both disciplines. Among the publications authored is Sanctity of Life and Quality of Life in the Context of Medicine, Ethics and Law (1979). He is presently editing a book on cross-cultural aspects of the interaction of ethics and law in biomedicine.
Michael McDonald occupies the Maurice Young Chair in Applied Ethics and is the founding Director of the Centre for Applied Ethics at the University of British Columbia. He is the author of various publications in applied ethics, including The Ethics Reading Handbook (for the Certified General Accountants of Canada) and Towards a Canadian Research Strategy for Applied Ethics (for the Social Sciences and Humanities Research Council of Canada). He has also published in ethics, political philosophy and philosophy of law, especially in the area of minority collective rights. McDonald served as Deputy Chair of the Tri-Council Working Group on Ethics that produced The Code of Ethical Conduct for Research Involving Humans. McDonald is past-President of the Canadian Philosophical Association and the former Editor of Dialogue.
Pinit Ratanakul received his PhD in Philosophy from Yale university and is the Director of the Center of Religious Studies, Mahidol University, Thailand.
Sheryl Reimer Kirkham, RN, MSN, is a Doctoral Candidate at the University of British Columbia, School of Nursing. Her dissertation research is a critical ethnography of “Intergroup Dynamics in Health Care Provision in a Pluralistic Society”, with a focus on processes of racialization. This research builds on her Masters Thesis “Nurses’ Descriptions of Caring for Culturally Diverse Clients”. She was formerly on faculty at Camosun College, Victoria, as Nurse Educator and has published and presented on topics such as cross-cultural nursing, research methodology, and nursing curriculum.
Patricia (Paddy) Rodney is an Assistant Professor at the University of Victoria School of Nursing in British Columbia (Lower Mainland Campus). She is also a Research Associate with the University of British Columbia (UBC) Centre for Applied Ethics and Providence Health Care Ethics Services. Dr Rodney teaches and consults in health care ethics, and is a member of the ethics committees of B.C. Women’s Hospital, St Paul’s Hospital, and the North Shore Health Region. Dr Rodney graduated from the UBC School of Nursing’s PhD Program in the spring of 1997. Her studies have included an extensive focus on health care ethics and feminist ethics. More specifically, her feminist ethnographic research focuses on how nurses deal with ethical problems in their practice, and on how the culture of the health care system impairs the moral agency of nurses and other members of the health care team.
Peter H. Stephenson is Professor of Anthropology as well as a faculty member in the Centre for Environmental Health at the University of Victoria. He received his PhD from the University of Toronto in 1978. He has also served as editor of the journal Culture and as president of the Canadian Anthropology Society. He is author of The Hutterian People and senior editor of A Persistent Spirit: Towards understanding Aboriginal Health in British Columbia. He has also written many journal articles and book chapters. Professor Stephenson was the 1997 recipient of the Weaver- Tremblay award given by the Canadian Anthropology society for achievements in applied anthropology. He has worked with many immigrant and refugee communities in Canada, with First Nations communities, and in the Netherlands, on issues related to health care, aging, and the environment.
Rosalie Starzomski, RN, PhD, is Assistant Professor at the University of Victoria School of Nursing in British Columbia (Lower Mainland Campus) and a Research Associate with the University of British Columbia (UBC) Centre for Applied Ethics. She is an Ethics Consultant at the Vancouver General Hospital, a member of the Vancouver General Hospital Ethics Committee, and is involved in teaching and consulting in the area of health care ethics and health policy. Dr Starzomski received her PhD in Nursing from UBC in 1997 and her dissertation “Resource Allocation for Solid Organ Transplantation: Toward Public and Health Care Provider Dialogue” examined moral reasoning around ethical issues related to organ transplantation as well as community participation in health care decision making. Her current research is focused in the areas of health care ethics, health policy, organ transplantation, nephrology, and genetic testing.
Khannika Suwonnakote, RN, PhD, is a graduate nurse faculty member of Ramathibodi School of Nursing, Mahidol University ,Bangkok, Thailand. She is a former Vice Dean in Nursing Affairs, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, former director of the Graduate Program in Nursing. She also is a chair of nursing ethics development committee and a chair of the Nursing Ethics Course of the undergraduate nursing curriculum.
Sumana Tangkanasingh received her Doctoral du troisieme cycle in sociology from Grenoble University and is teaching in the Department of Humanities, Faculty of Social Sciences and Humanities, Mahidol University, Thailand.


The ethical theories employed in health care today assume, in the main, a modern Western philosophical framework. Yet the diversity of cultural and religious assumptions regarding human nature, health and illness, life and death, and the status of the individual suggest that a cross-cultural study of health care ethics is needed.
A Cross-Cultural Dialogue on Health Care Ethics provides this study. It shows that ethical questions can be resolved by examining the ethical principles present in each culture, critically assessing each value, and identifying common values found within all traditions, It encourages the development of global awareness and sensitivity to and respect for the diversity of peoples and their values and will advance understanding as well as help to foster a greater balance and a fuller truth in consideration of the human condition and what makes for health and wholeness.