Cultural Awareness: Fitness to practice guidance

The UK is culturally diverse with almost every nationality, religion and social belief system being present in our society. As such, it is important that registrants remain culturally aware when treating patients, recognising, respecting and being sensitive to the people and communities which they serve.

For any healthcare professional, it is important that they rise beyond the ‘unconsciously unaware’ stage of cultural awareness, recognising that diversity in people goes far beyond physical appearance or dress. 

Recently the GCC has received a complaint where a registrant failed to recognise or appreciate the cultural impact of their actions when asking a patient to remove a religious garment (intended to cover the entire body) without due explanation or reason.

Standard A2 of the GCC Code states that chiropractors must, “respect patients’ privacy, dignity and cultural differences…”. As such, all registrants are reminded to communicate with their patients effectively and openly regarding any proposed course of treatment, including the requirement to remove clothing (and why), and to ensure that the patient gives consent in full or, if desired, with conditions such as having a chaperone present. Remember, effective communication is achieved when the patient fully understands the proposed treatment requirements, allowing them to make an informed decision in conjunction with their personal and cultural beliefs.

Finally, registrants are again reminded that some common or daily occurrences within practise may inadvertently infringe cultural and/or social boundaries of a patient, for example a patient having to remove religious clothing, undress or being alone with a person of the opposite sex in a treatment room.

Cultural Awareness Checklist

1. Establish and maintain effective communication throughout all patient engagements
2. Be aware of non-verbal cues without jumping to conclusions. Don’t make assumptions without know the person’s customs or beliefs that may be important within a clinical situation ie. removal of clothing
3. Ask openly about potentially relevant traditions and customs
4. Use normalising statements eg. ‘Many of my patients have personal beliefs or customs that are important for me to know so I can provide the best possible care.’
5. Fully explain the need for the patient to remove any religious garments eg. clothing which cannot be adjusted in order to undertake the examinations and therefore necessary for the patient to remove the garment as well as checking that the patient is willing to proceed on that basis
6. Examine and be aware of your own biases (conscious and unconscious) so you can better realise and control them