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SAFELY EMBRACING CULTURE: THE ADEQUACY OF THE CULTURAL SAFETY PARADIGM... may help learning, but are not guaranteed to improve practice. As such, the cultural safety paradigm, despite being vague, may have design characteristics that lose their power outside of a nursing or educational context. Despite all of the aforementioned possible concerns, cultural safety has been argued to be efficacious in both Canada* * and the U.S. healthcare systems. However, this efficacy must be taken with a grain of salt. As with any measure of success, the efficacy of the cultural safety paradigm must be measured relative to some metric set out by its users (after all, the paradigm lacks an accountability framework to measure itself by). In Canada and the U.S., this metric is the amount of knowledge on Indigenous cultures the paradigm garners. Put differently, the appropriated form of cultural safety prioritizes ethnographic knowledge, which is not the same as cultural understanding. Indeed, an ethnographic focus is very reminiscent of the historically proven ineffective primacy of Indigenous bodies, rather than Indigenous persons.” There are a myriad of examples of this ethnographic overreliance, which include, but are not limited to: a proclivity of medical research to conduct descriptive studies on Indigenous populations, rather than measurement or intervention-based studies.*® *” Indigenous specific adverse childhood experience diagnostics,“ selectively screening for intergenerational trauma in physician encounters,”” and inadequately engaging target individuals in community-based participatory research projects.’ These sorts of knowledge pursuits are not completely devoid of usefulness, but they lead us to conceptualize “understanding” in a problematically narrow way. It is here where the appropriated form of cultural safety moves from possible to very real concerns. 42 Lynden Lindsay Crowshoe et al., Exploring Canadian Physicians’ Experiences with Type 2 Diabetes Care for Adult Indigenous Patients, Canadian Journal of Diabetes, Vol. 42, No. 3 (2018), 281-288. 3 Rachelle D. Hole et al., Visibility and Voice: Aboriginal People Experience Culturally Safe and Unsafe Health Care, Qualitative Health Research, Vol. 25, No. 12 (2015), 1662-1674. 4 Dawn Doutrich et al, Cultural Safety in New Zealand and the United States: Looking at a Way Forward Together, Journal of Transcultural Nursing, Vol. 23, No. 2 (2012), 143-150. Maureen K. Lux, Seperate Beds, 29. 16 Alika Lafontaine, Indigenous Health Disparities: A Challenge and an Opportunity, Canadian Journal of Surgery, Vol. 61, No. 5 (2018), 300-301. # Robert Sanson-Fisher et al., Indigenous Health Research : A Critical Review of Outputs over Time, The Medical Journal of Australia, Vol. 184, No. 10 (2006), 502-505. 18 David Finkelhor et al, A Revised Inventory of Adverse Childhood Experiences, Child Abuse & Neglect, Vol. 48 (2015), 13-21. © Amy Bombay — Kimberly Matheson — Hymie Anisman, The Intergenerational Effects of Indian Residential Schools: Implications for the Concept of Historical Trauma, Transcultural Psychiatry, Vol. 51, No. 3 (2014), 320-338, https://doi.org/10.1177/1363461513503380 (accessed 5 December 2020). 5° Eileen Pittaway — Linda Bartolomei — Richard Hugman, Stop Stealing Our Stories: The Ethics of Research with Vulnerable Groups, Journal of Human Rights Practice, Vol. 2, No. 2 (2010), 229-251. 45
