Effecting Cultural Change

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From a researcher or policymaker's point of view and on an international scale, policy analysis and management professor Andrea Parrot stresses that ethics are culturally and historically determined. When members of one culture try to impose their ethics and values on another culture, the situation is inherently complex.

Parrot is an expert in cultural practices and the risks encountered in attempting to change them. She is currently writing a book on the topic with Nina Cummings, health educator and victim advocate at Gannett University Health Services at Cornell. Forsaken Figures: The Global Brutalization, Oppression, and Violence against Women catalogues, describes, and analyzes all manner of violence, subjugation, and gendercide against women from a global perspective. Many practices and cultural norms around the world, such as female genital mutilation, sexual slavery, and feticide/infanticide of female babies, are perceived as wrong by outside cultures, Parrot says. She is interested in determining how outside policymakers might begin to address what they see as problems when their own cultural language is vastly different from that of the communities and countries in which the practices are tolerated or even supported.

Parrot points out that American values and ethics have changed significantly in the past century. In the early twentieth century, for example, every doctor took the Hippocratic oath, which stated that doctors would not perform abortions, use a knife, or give patients information that could harm them in any way. Although the original oath is considered outdated today and revised versions have taken its place in medical schools, just a century ago this was the ethic that determined how doctors should interact with patients.

Culture influences ethics as much as changing times do, Parrot points out. In Canada, the United Kingdom, and many other countries with nationalized health insurance, the foremost medical ethic is justice, or equal access to health care. In the United States, where there is no standardized universal health care, equal access is one of the least important ethical principles considered; instead, autonomy is paramount. In most situations, patients have the final word on whether a medical procedure is performed on them or not. The reverse is true, as well — patients can seek out a particular medical treatment and demand it, even if a doctor does not recommend it. If one doctor will not perform the procedure, the implication is that the patient can, and will, shop around until he or she finds a doctor who will.

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