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SAFELY EMBRACING CULTURE: THE ADEQUACY OF THE CULTURAL SAFETY PARADIGM... LINGUISTIC DIFFICULTIES Linguistically, “cultural safety” implicitly permits a host of oppressive behaviours. A physician who receives a bulletin about their hospital adopting culturally safe care programs is probably not going to be well versed in the definition or history of the paradigm. Indeed, they are likely only going to engage with the paradigm insofar as they adhere to the expectations laid out by their workplace. It is possible that these expectations may be incredibly close to the intentions of the paradigm’s ideal form, but (at least in Canada and the U.S.) this is unlikely. Even so, there are many things that “cultural safety” insinuates that may lead to unethical behaviour in an uninitiated individual. The term “cultural” is not inherently problematic, but can become concerning when interpreted in the wrong way. When used appropriately (as intended by the ideal form of the paradigm), “cultural” means belonging to a group of people within a system of shared values. In this, the idea of culture applies equally to both Indigenous cultures and medical culture, invoking an understanding and reflection on both. When used inappropriately, the term “culture” insinuates an othering wherein "culture" is defined in anthropological terms most consistently by its proximal relationship to difference”. That is, using the term “culture” to refer to anything that is not part of the sphere in which it is being invoked (i.e., Indigeneity and medical dogma). This creates a sense in which Indigenous culture contributes to the body of knowledge that is medicine, but medicine does not reciprocate nor should it be expected to. This oppresses Indigenous cultural understanding to an epistemic status unworthy of the same consideration of dogmatic medical understanding. The term “safety” is much more concerning. “Safety” implies that a certain group is vulnerable and another authority/purveyor group is responsible for making the vulnerable group safe. Although identifying and caring for vulnerable persons is important, it inherently divides and inequitably establishes power relationships. In the case of medicine, these power relationships already exist, and are a large reason why the rapport between medicine and Indigenous individuals is so poor. Indigenous people do not need to be protected or saved, they need to be respected and understood. Assuming otherwise only serves to perpetuate colonial ideals like “saving the savages”. 54 Audra Simpson, On Ethnographic Refusal: Indigeneity, “Voice” and Colonial Citizenship, Junctures: The Journal for Thematic Dialogue, Vol. 0, No. 9 (2007), 70.
