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ERIC SMITH
There are considerable differences between the Maori, for which the
cultural safety paradigm was designed, and Canadian and U.S. Indigenous
populations. Since New Zealand is a much smaller country than Canada or
the U.S., land claim agreements between the Maori and the New Zealand
government are much more well-defined than they are with Indigenous
Canadians or Americans.*° This makes delineations of political sovereignty
much easier to establish. Moreover, the Maori people, while not completely
homogenous, share a common language and culture that is protected by
federal law (e.g., the Treaty of Waitangi), while Canadian and American
Indigenous people are incredibly diverse in both language and culture that
is legally protected to varying degrees.*”” ** Therefore, while understanding
“the” Maori culture is not easier per se, it is at least possible. Understanding
“the” Canadian or American Indigenous culture is a pointless endeavour; the
actual political and cultural complexities of these Indigenous populations do
not reflect such unanimity.
It should also be noted that the differences in healthcare structure and
provision in Canada and the U.S. are not insignificant. Canada and the
U.S. differ in many ways, each of which will alter the ways in which an
ideology-modifying paradigm implicates its stakeholders; the most obvious
difference being the public versus private approaches to healthcare funding.
However, there are more direct differences regarding each country’s address
of Indigenous persons. For example, it has been argued that the Canadian
Institutes of Health Research (CIHR) is currently encouraging more
collaboration with Indigenous groups than its American counterparts.*
However, the primary concern of this paper is to recognize the limits of
appropriating cultural safety, regardless of circumstance. In healthcare
systems as antagonistic to pluralistic healthcare (which involves more than
strict adherence to biomedicine) as Canada and the U.S.,* these limits
are sure to lead to undesirable outcomes irrespective of some structural
differences. Cultural safety may also be limited by its design as a pedagogical
tool for nurses.*! Extending the paradigm to healthcare more generally (which
Canada and the U.S. have done) assumes some form of transferability that
may not actually exist. It seems intuitive that nursing education and general
healthcare, regardless of cultural context, are distinct in a number of relevant
ways. Educational aids (which could include ideology-modifying paradigms)
Maggie Cywink, Why the Indigenous in New Zealand Have Fared Better than Those in
Canada, The Conversation, 15 October 2017, 1.
Cywink, Why the Indigenous, 1.
Daschuk, Clearing the Plains.
39 Tallbear, Native American DNA, 186-189.
Maureen K. Lux, Seperate Beds, 5.
Rose McEldowney - Margaret J. Connor, Cultural Safety as an Ethic of Care: A Praxiological
Process, Journal of Transcultural Nursing, Vol. 22, No. 4 (2011), 342-349.