Chapter 2: Respecting and responding to cultural practice and traditions

Decision-making

My culture says
Pastor Efrem explains how care decisions may be made and communicated. (3:22)Video transcript

Decision-making can be affected by language, and cultural expectations and practices.

Who is the decision-maker?

The responsibility and authority for making decisions about the patient vary according to culture. This may affect how you keep the patient at the centre of your care. 

Whenever possible, find out from the patient how they want to be involved in care decisions. In some situations, the patient may designate one or more family members or a spiritual leader as the person providing information and making decisions about care and treatment. Take the time to inquire about how best to share information and make decisions.

Sometimes many family members are present around the time of death. This can make it difficult to determine who speaks for the family about care of the body and other decisions related to the death. Take time to introduce yourself and ask each person present to introduce themselves. This will give you a sense of who’s who and who seems to speak for the family. If unsure, ask the family who will help you with decision-making. If an elder or spiritual leader is present, they may be helpful in identifying who will take the lead in this regard.

Working with cultural process

In some cultures, decisions about personal health matters and care of the body involve many people and take time. Patience and respect is needed as you make decisions together with a family. Communicate clearly your timelines and ask how these will work for them. Keep at it until you agree on a decision-making schedule and process that works for you and the family.


Conversation Prompts

Who should we communicate with when we need to make decisions? 

Who speaks for the patient or family?