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ERIC SMITH
mortality rates and the mortality rates of their White counterparts, thereby
doing nothing more than revealing what was already known, "that poverty,
not tuberculosis, was the greatest threat to Native infants."?" Misguided
attempts at understanding Indigenous culture like this are not limited to the
distant past. While the exact form of the oppression/subjugation changes
by circumstance, treating Indigenous groups as things to be studied, rather
than people to be understood and helped, has been consistent throughout
history. As Kim Tallbear (2013) puts it, "Native American [and/or Indigenous]
bodies, both dead and living, have been sources of bone, and more recently
of blood, spit, and hair, used to constitute knowledge of human biological
and cultural history.””° Bodies, not people, are given epistemological primacy.
An understanding of Indigenous culture is needed in North American
healthcare, but this understanding must be sought out in ways that do not
perpetuate these colonial ideals.
As previously mentioned, the Canadian and American healthcare systems
have long been attempting to avoid perpetuating their misguided ignorance,
with little success. However, some of these attempts have been much more
successful than others. One of the most celebrated of these (relatively)
successful ventures into cultural understanding is known as the cultural safety
paradigm. The paradigm, originally developed by a small group of Maori
nursing students, is intended to act as means of modifying the ideologies of
healthcare to promote values of holistic, humble, and responsive care provision.
In essence, the paradigm blankets all of the principles of healthcare (e.g., respect
for persons, beneficence, non-maleficence, etc.), and encourages a distancing
from their implicit colonial inclinations towards epistemic and praxiological
oppression. The paradigm appeared to demonstrate positive outcomes in its
first years of implementation in New Zealand and, as such, many healthcare
theorists and policy makers in Canada and the U.S. began to adopt and adapt
the cultural safety paradigm. Thirty years later, I find myself hard-pressed
to find healthcare programing that does not hold cultural safety as the gold
standard of appropriate and effective Indigenous care. At the same time, I have
also grown increasingly aware that many healthcare providers pride themselves
on their culturally safe practice without fully knowing what it is they are proud
of or how being “culturally safe” may not be as desirable as we think.” 2?
1 Ibid., 289-290.
2 Kim Tallbear, Native American DNA: Tribal Belonging and the False Promise of Genetic
Science, 1“ edition, Minneapolis, University Of Minnesota, 2013, 2.
21 Elaine Papps — Irihapeti Ramsden, Cultural Safety in Nursing: The New Zealand Experience,
International Journal for Quality in Health Care, Vol. 8, No. 5 (1996), 491-97,
https://doi.org/10.1093/intqhc/8.5.491 (accessed 5 December 2020).
2 Alison J. Gerlach, A Critical Reflection on the Concept of Cultural Safety, Canadian Journal
of Occupational Therapy, Vol. 79, No. 3 (2012), 151-58,
https://doi.org/10.2182/cjot.2012.79.3.4 (accessed 5 December 2020).
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