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OCR
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). + 248 +
