Cultural Frameworks: Informed Consent in Indigenous Healthcare

This presentation delves into the critical aspect of informed consent within the context of Indigenous healthcare, addressing the ethical and legal requirements alongside the unique challenges presented by cultural and linguistic differences. It emphasizes the importance of informed consent as a cornerstone of patient-centered care, highlighting its role in upholding patient autonomy and fostering trust. The presentation identifies barriers such as language difficulties, cultural beliefs, and historical experiences that can hinder effective communication and comprehension, leading to misunderstandings and potential conflicts. The analysis underscores the need for healthcare professionals to develop cultural competency and adopt culturally appropriate communication strategies to ensure that Indigenous patients are fully informed and empowered to make decisions about their healthcare. This resource aims to provide insights and practical guidance for navigating the complexities of informed consent in Indigenous healthcare settings, promoting ethical practice and improving health outcomes. Desklib offers various resources, including solved assignments and past papers, to support students' learning and academic success.

Running head: SUPPORTIVE PAPER
Supportive paper
Name of the student:
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Author note:

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Introduction:
Indigenous population pose a significant risk to the health care delivery due to the
stark differences that they reflect in their culture and tradition. It has to be mentioned in this
context that the culturally diverse patient groups often experience a significant inequality in
the care experience and delivery (Hall, Prochazka & Fink, 2012). One great aspect of care
delivery which has encountered considerable challenges when involving the indigenous
community is the informed consent, an integral component of patient centred care delivery
and ethical aspects of care. This presentation will allow me to illustrate the aspect of
informed consent and how it applies to the culturally diverse population of indigenous
individuals.
Informed consent:
Informed consent can be defined in the health care context as the process of acquiring
the permission from a patient respectfully before conducting a healthcare intervention or
assessment activity. However, in the aspects of health care, the informed consent is also used
as the implementation of an ethical course of activity which allows the professional to take
permission before he or she can disclose any personal information (Grady, 2015).
It has to be mentioned that informed consent has become of the greatest aspects of
clinical treatment which is practiced all across the globe and is a vital component of the
contemporary medical practice. Delving deeper into the ideation of the informed consent, it
has to be mentioned that this particular component is associated with three overarching
components of care delivery procedure, legal, ethical, and administrative compliance.
Here I would like to explain the fact that in context of legal aspects, informed consent
allows the patient to have a mandatory right to claim the choices and preferences. Hence, the

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care professional taking part in the process of informed consent will have the chance to allow
the patient to have a priority basis of decision making power to either allow or refuse any
care activity (Faden, Beauchamp & Kass, 2014).
This also is overlapped with the ethical aspects of the care delivery context, it has to
be mentioned that the patients have an autonomous right decision making and take equal part
in the establishment of the defined goals. The informed consent automatically co-relates both
of the aspects in care setting or scenario. Elaborating more, while asking for informed
consent, patients are asked whether or not they want to take part in the care activities. Hence,
this particular activity immediately takes into consideration giving the patient autonomous
decision making power and helps in re-orienting the care goal setting into a more patient
defined genre.
Informed consent has multidimensional benefits, and administrative compliance is the
next most effective benefit of this ethico-legal component. Yoshizawa et al. (2017) have
discussed that informed consent is a written legal document that takes into consideration that
is a proof of all the parties being involved with the procedure. Along with that the informed
consent document also allows the care professionals to have an effective safeguard that
allows nominal fulfilment of the ethical and legal requirements of care delivery procedure.
Informed consent for aboriginals:
Informed consent is an ethical and legal requirement for conducting any research or
treating any patient in the clinical setting. Informed consent is an inevitable requirement
before any procedure of diagnosis or treatment is undertaken in the clinical setting. It
provides the liberty to every participant for deciding whether to refuse or accept the
recommended treatment. However, obtaining informed consent and maintaining
confidentially of the patient become increasingly challenging while treating the indigenous

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population (Ashmran et al., 2016). The challenges are growing in several directions which
significantly affect the health of the indigenous population, especially women in the
population. A study suggested that language is one of the prime barriers for seeking informed
consent from aboriginal women of Torres Strait island (Orozco et al., 2017). In the majority
of the cases, the individual who signs the consent letter form does not have the full
understanding of the statement started in the form. Therefore, the procedure hinders the
effective treatment interventions of the disease. Misunderstanding is another evident barrier
due to incorrect language translation by a translator. In a majority of the cases, individuals
sign the consent form without unaware of the content of the form which results in the
withdrawal of the consent at the later stage of the treatment procedure (Regmi et al., 2017).
Informed consent for giving liberty to every individual for choosing their choice of
recommended treatment. However, in a considerate case, the decision is influenced by
religious beliefs, and it becomes an area of conflict for proceeding with accurate treatment
(Varcoe et al 2017).
Consequently, the mortality rate and burden of the diseases increases exponentially as
compared to the modern part of the country. Moreover, the religious beliefs and language
barriers are dissolved; sometimes the false expectation and past experiences become massive
barriers to treatment procedure. Personal beliefs also influence the agreement of informed
consent. A significant number of individuals tend to think that conventional treatment is the
best way of curing any disease and refuse to receive any recommended treatment out of the
conventional treatment. Thus, it influences the health crisis of the population and the majority
of the individual suffers from the incurable disease. Lack of sound knowledge about the topic
significantly influences their refusal in giving the informed consent for proceeding with the
treatment. Sometimes, it may happen that the physician or nurses or interviewer belong to the
non-indigenous part of the country and have no knowledge of the religion and personal

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beliefs. Therefore, the approaches towards the patient who belong to the original part of the
country are not up to the expectation. Consequently, the patients feel offended and refuse to
provide the consent for the treatment, and the burden of health crisis increases exponentially.
Therefore, seeking informed consent is difficult to obtain for the indigenous women and may
require special care for obtaining the informed consent.
Relation and discussion:
The informed consent is undoubtedly a very important aspect of the care delivery
scenario, it is not just an ethical form to fill, it is a legislative component, missing out on
which can lead to professional issues and can lead to penalizing the health care professional
associated with it. The indigenous populations on the other hand are associated with many
language and culture oriented barriers which further complicates the care delivery scenario
for the minority target patient group. It has to be mentioned that the language and cultural
differences are associated with various barriers and challenges in care delivery scenario for
the patient groups. For aboriginals, the culture and tradition also differs drastically in
accordance to the care delivery scenario (Blum & Murray, 2016). A lot of activities are
considered disrespectful and offending in the aboriginal populations and the informed
consent provides the chance to the aboriginals to check beforehand the aspects of care before
agreeing to it. It has to be mentioned that however, the language problem and the aspects of
care is undoubtedly a grave concern which complicates the process of informed consent from
the culturally diverse patients. This allows health care professionals like us to understand
what skills need to be further developed to allow the informed consent process to be
completed accordingly, even for culturally diverse population (Castellano, 2014).
Personal reflection:

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This presentation had given me the optimal opportunity to understand how, informed
consent, one of the most important ethico-legal aspects of care delivery, plays into health care
scenario for aboriginal patient groups. The barriers and challenges that are prevailing in the
scenario has given me a clear ideation regarding the need for more culturally appropriate
communication skills and approach of tone. I have gathered a wealth of knowledge that
would help me in the future to develop the exact action plans which will help me in the future
to understand how to effectively and successfully carry out patient informed consent
procedure. The research carried out for the presentation had been mostly based on Google
scholar and the data gathered had been accumulated precisely by me. This experience also
helped me discover how to carry out evidence based practice in the future as well.
Conclusion:
On a concluding note, this has to be mentioned that this activity helped me identify
exactly how to carry out a detailed literature search and develop a detailed account of the
ethical topic chosen for the assignment with respect to my specialty area, the aboriginal care
delivery. There are a few considerable barriers that I have identified that hinders effective
informed consenting among the aboriginals. It can be hoped that the experience and
knowledge gained from this activity will help me improve the cultural appropriateness of my
practice and will help me adhere to the ethical and legal aspects effectively.

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References:
Ashman, A. M., Collins, C. E., Weatherall, L., Brown, L. J., Rollo, M. E., Clausen, D., ... &
Lumbers, E. R. (2016). A cohort of Indigenous Australian women and their children
through pregnancy and beyond: the Gomeroi gaaynggal study. Journal of
developmental origins of health and disease, 7(4), 357-368.
Blum, A., & Murray, S. J. (Eds.). (2016). The ethics of care: Moral knowledge,
communication, and the art of caregiving. Routledge.
Castellano, M. B. (2014). Ethics of Aboriginal Research1. Global bioethics and human
rights: Contemporary issues, 273.
Faden, R. R., Beauchamp, T. L., & Kass, N. E. (2014). Informed consent, comparative
effectiveness, and learning health care. N Engl J Med, 370(8), 766-768.
Grady, C. (2015). Enduring and emerging challenges of informed consent. New England
Journal of Medicine, 372(9), 855-862.
Hall, D. E., Prochazka, A. V., & Fink, A. S. (2012). Informed consent for clinical
treatment. Canadian Medical Association Journal, 184(5), 533-540.
Orozco, F., Ochoa, D., Muquinche, M., Padro, M., & Melby, C. L. (2017). Awareness,
Comprehension, and Use of Newly-Mandated Nutrition Labels Among Mestiza and
Indigenous Ecuadorian Women in the Central Andes Region of Ecuador. Food and
nutrition bulletin, 38(1), 37-48.
Regmi, P. R., Aryal, N., Kurmi, O., Pant, P. R., Van Teijlingen, E., & Wasti, S. P. (2017).
Informed consent in health research: challenges and barriers in low‐and middle‐
income countries with specific reference to Nepal. Developing world bioethics, 17(2),
84-89

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Varcoe, C., Browne, A. J., Ford‐Gilboe, M., Dion Stout, M., McKenzie, H., Price, R., ... &
Khan, K. (2017). Reclaiming Our Spirits: Development and pilot testing of a health
promotion intervention for Indigenous women who have experienced intimate partner
violence. Research in nursing & health, 40(3), 237-254.
Yoshizawa, G., Sasongko, T. H., Ho, C. H., & Kato, K. (2017). Social and communicative
functions of informed consent forms in East Asia and beyond. Frontiers in
genetics, 8, 99.