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SAFELY EMBRACING CULTURE: THE ADEQUACY OF THE CULTURAL SAFETY PARADIGM...
be the medical culture. As such, healthcare systems synthesize knowledge in
a way that conforms to systemic ideals, which appropriates and misrepresents
Indigenous cultures. In this, even the appropriated form of cultural safety
perpetuates the very thing it was working against, ignorance of the actual
nature of Indigeneity. While this may seem needlessly speculative, it does
not seem too far-fetched, considering that the paradigm itself has been
appropriated and misused from its original design to suit the Canadian and
American context.
Another important concern of justice has to do with who controls the
knowledge of Indigenous cultures and lived experience created by the
appropriated paradigm. If the medical community are the sole owners of this
knowledge, then Indigenous communities lose any ability to control the way
in which healthcare providers perceive them. If the Indigenous community
are the sole owners of this knowledge, then the medical community loses
the ability to understand Indigenous cultures and create more effective care.
This is why understanding is so important. It necessarily requires value
exchange and engagement from both parties involved, meaning that both
parties own the understanding created. Some systemic preventative measures
such as the Canadian First Nations principles of Ownership, Control, Access,
and Possession (OCAP) for Indigenous research have been put in place to
try to enforce this sort of co-ownership, but they are rarely meaningfully
followed.
STEPPING FORWARD FROM CULTURAL SAFETY
It is here that one may suggest that cultural safety is not really problematic.
Supposing we avoid the appropriative mistakes currently being committed and
adhere to the true goals of the paradigm we should be able to at least somewhat
improve our current healthcare. However, this suggestion misunderstands
what the concerns of the paradigm are. It is the very fact that it has been and
continues to be appropriated in ineffective ways that it is so dangerous. If the
paradigm were as excellent as advertised, surely these mistakes would not be
occurring. Cultural safety should not purport itself to be the end of effective
inter-cultural understanding and engagement in healthcare. It is a step
towards the positive end of the continuum, but not the end of progress. In an
excellent address on the current state of affairs, Mary Jane Logan McCallum
& Adele Perry state the following:
°° Kathi Wilson — Nicolette Cardwell, Urban Aboriginal Health: Examining Inequalities
between Aboriginal and Non-Aboriginal Populations in Canada, The Canadian Geographer,
Vol. 56, No. 1 (2012), 107-116.