Diversity, Equity and Inclusion - Commitment to Ethical Practice

In the healthcare setting, it is both a professional, ethical, and legal responsibility that care be provided in a manner that protects and respects the dignity of the patient. RTs must identify, reduce, and eliminate inequitable outcomes and power imbalances to provide care to patients/clients with diverse values and beliefs without prejudice. Examples of discrimination included those based on age, gender identity or expression, sexual orientation, culture, race, religion, disability, or medical condition. A practitioner therefore must recognize bias and become competent in providing inclusive and equitable care through the process of gaining a congruent set of behaviours and attitudes.

A male RT attending a delivery is told he is not permitted to be in the delivery room because the mother’s cultural beliefs prohibit any man other than her husband and the physician from being present. However, the therapist in question is the only RT available to provide any necessary resuscitative care. Should he disregard the mother’s request and attend the delivery in the delivery room?

The ethical principles involved are respect for free will, balanced with the need to do good and do no harm.

Where possible, accommodation should be sought that would honour the mother’s wishes, while at the same time ensuring that safe, optimal care is provided to her newborn infant. For example, arrangements could be made to have the resuscitation team ready to receive the infant in an adjoining room immediately after delivery.

8 Steps to Cultural Competence for Healthcare Professionals

(IWK Health, 2006)

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1. Examine your values, behaviours, beliefs, and assumptions.

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2. Recognize racism and the behaviours that breed racism.

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3. Engage in activities that help you to reframe your thinking, allowing you to hear and understand other world views and perspectives.

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4. Familiarize yourself with the core cultural elements of the community you serve.

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5. Engage patients/ clients to share how their reality is similar to, or different from, what you have learned of their core cultural elements.

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6. Learn how other cultures define, name and understand disease and treatment.

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7. Develop a relationship of trust with patients/clients and co-workers by interacting with openness, understanding and a willingness to hear different perceptions.

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8. Create a welcoming environment that reflects the diverse community that you serve.

An 81 year old patient in the ICU is being discussed by the healthcare team at rounds. A comment is made by the most responsible physician that, without speaking to the family, they will not be treating the patient as aggressively as they would if they were younger, given that their condition “is normal for an elderly person”. Is this a biased opinion?

The ethical principles involved are to act fairly, and to do good and do no harm.

Ontario’s Human Rights Code outlines the right of every Ontario resident to receive equal treatment with respect to goods, services and facilities without discrimination based on a number of grounds including race, age, colour, sex, sexual orientation, and disability. Respiratory Therapists are therefore required to comply with this Code when providing care to patients/clients. Broadly, this means that services are to be provided equally to all regardless of race, ancestry, place of origin, colour, ethnic origin, citizenship, creed, sex, sexual orientation, age, marital status, family status and/ or disability (Ont. Human Rights Code,1990).