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OCR
ERIC SMITH ETHICAL RAMIFICATIONS Measuring efficacy by way of ethnographic productivity creates a heuristic for empirically tracking a paradigm that is inherently difficult to track. Healthcare systems are then led to erroneously correlate an enumeration of ethnographic knowledge with a degree of understanding. Supposedly, the more knowledge on Indigenous people a healthcare system has, the greater capacity the system has to integrate this knowledge, creating “understanding”. However, while knowledge is certainly required for understanding, knowledge and understanding are not the same thing. I can know the first 100 digits of the number pi and recite them to anyone who asks, but this does not mean that I actually understand the important function of this number in something like calculating the area of a circle. Indeed, my “understanding” of pi would be very limited, considering my removed perspective from what the number actually represents in practice. Likewise, utilizing cultural safety in this way has led to healthcare developing a removed concept of Indigenous understanding that only serves to perpetuate epistemic oppression and problematic ideals of race-based medicine. The means by which Canada and the U.S. are applying cultural safety are not entirely problematic. There are a limited number of good reasons for using race-based medicine, most of which have to do with the etiology of illness.* Certain illnesses disproportionately or differently impact different groups (e.g., sex-linked chromosomal illnesses). In these cases, there is good reason to purposefully seek out knowledge that separates those who are susceptible and those who are not. There is also reason to think that the ethnographic primacy of cultural safety is an expeditious route to achieving an understanding of Indigenous persons. After all, ethnographic study does not (usually) require time or resources dedicated to building mutually beneficial relationships with target community members. Observation creates data; data create knowledge bases; knowledge bases create foundations for understanding and mutual benefit. However, these benefits could result from the application of any knowledge-promoting paradigm. It is also dangerously optimistic to think that unidirectional and externally directed ethnography (i.e., healthcare observing the community, but not themselves) is able to “render simply transparent representations of what is culturally ‘out there”. The ethical risks of this sort of racially fuelled ethnography only stand to instantiate the erroneous divides between groups of people.? Jonathan M. Kaplan, When Socially Determined Categories Make Biological Realities: Understanding Black/White Health Disparities in the U.S., The Monist, Vol. 93, No. 2 (2010), 282. 52 Tallbear, Native American DNA, 14-15. Kaplan, Socially Determined Categories, 282-283.
