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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.
