This paper describes an innovative curriculum in cross-cultural clinical ethics developed by faculty in the Health Ethics and Law program at one Canadian university. The pedagogical approach explicitly uses the notion of relativism in bioethics to encourage (rather than compromise) the use of a standard western bioethics framework for ethical decision-making. It offers an argument, at the intersection of medical anthropology and bioethics, for a pedagogy in ethics that encourages clinicians to challenge Euro-American constructs such as “autonomy” while simultaneously working within a principles-based framework for ethical decision-making. This approach is based on the premise that training in cross-cultural clinical ethics requires a “critical consciousness” approach to cross-cultural health care. Such an approach is enhanced by the use of cases that illustrate how the ideas and practices of medicine itself are culturally embedded and socially, economically, and politically constituted. A pedagogical approach to clinical ethics that works from within a critical consciousness framework encourages a critique of Euro-American based normative assumptions of bioethics while working within a principles-based framework for ethical decision-making. The curriculum features six key learning points taught through case-based discussion. The learning points emphasize culture in its relation to power and underscore the importance of viewing both biomedicine and bioethics as culturally constructed.
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