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Current controversy
Translating Cultural Safety to the UK
  1. Amali U Lokugamage1,2,
  2. Elizabeth(Liz) Rix3,
  3. Tania Fleming4,
  4. Tanvi Khetan5,
  5. Alice Meredith5,
  6. Carolyn Ruth Hastie6
  1. 1Department of Clinical and Professional Practice, University College London Medical School, London, UK
  2. 2Department of Women's Health, Whittington Health NHS Trust, London, UK
  3. 3Faculty of Health, Southern Cross University, Gold Coast Campus, Bilinga, Queensland, Australia
  4. 4School of Midwifery, Auckland University of Technology, Auckland, New Zealand
  5. 5University College London Medical School Alumni, University College London, London, UK
  6. 6Department of Nursing and Midwifery, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
  1. Correspondence to Dr Carolyn Ruth Hastie, School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia; c.hastie{at}griffith.edu.au

Abstract

Disproportional morbidity and mortality experienced by ethnic minorities in the UK have been highlighted by the COVID-19 pandemic. The ‘Black Lives Matter’ movement has exposed structural racism’s contribution to these health inequities. ‘Cultural Safety’, an antiracist, decolonising and educational innovation originating in New Zealand, has been adopted in Australia. Cultural Safety aims to dismantle barriers faced by colonised Indigenous peoples in mainstream healthcare by addressing systemic racism.

This paper explores what it means to be ‘culturally safe’. The ways in which New Zealand and Australia are incorporating Cultural Safety into educating healthcare professionals and in day-to-day practice in medicine are highlighted. We consider the ‘nuts and bolts’ of translating Cultural Safety into the UK to reduce racism within healthcare. Listening to the voices of black, Asian and minority ethnic National Health Service (NHS) consumers, education in reflexivity, both personal and organisational within the NHS are key. By listening to Indigenous colonised peoples, the ex-Empire may find solutions to health inequity. A decolonising feedback loop is required; however, we should take care not to culturally appropriate this valuable reverse innovation.

  • applied and professional ethics
  • education for health care professionals
  • minorities
  • public health ethics
  • quality of health care

https://doi.org/10.1136/medethics-2020-107017

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    Footnotes

    • Twitter @Docamali, @tania_fleming2016, @CarolynHastie

    • E(L)R and TF contributed equally.

    • Contributors AUL conceived the idea of the paper and contributed to the manuscript. Both ER and TF contributed to the manuscript as joint second authors. CRH contributed to the manuscript, TV and AM both contributed to the manuscript. All authors drafted the work or revised it critically for important intellectual content, approved the final approval of the version published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests AUL is on the Board of Directors of the International MotherBaby Childbirth Organisation and also a member of a Patient & Public Voice Partners level 3 advisory group in NHS England (both roles are voluntary with no financial interests). TF, ER, AM, TK and CRH have no competing interests.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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