A critique of multi-culturalism in palliative care
The need to provide accessible and appropriate care to Britain’s growing numbers of Black and ethnic minority terminally ill people, has recently been recognised as a significant service development issue for many providers of palliative care. A report from the National Council for Hospice and Specialist Palliative Care Services (Hill and Penso 1995), identified a particular need for the provision of ‘culturally sensitive’ services in relation to the ‘spiritual, language and dietary’ needs of Black and ethnic minority service users. While such developments are both positive and welcomed, this chapter critically examines the predominant construction of Black and ethnic minority people’s needs in terms of cultural and religious needs. In particular, the chapter focuses upon the resurgence in popularity of cultural ‘factfile’ or ‘checklist’ approaches, as support resources to meet the training needs of health professionals. These approaches can be typified by their cataloguing of largely descriptive information on the cultural and religious practices of different Black and ethnic minority populations. In practical terms, factfiles appear to make positive contributions to the training needs of health-care professionals and to the quality of palliative care provision itself. However, a sociological consideration of the conceptual framework of resources suggests more ambivalent repercussions, in which their use can also legitimate complex repertoires of discrimination.
In critically examining factfile resources, this chapter draws upon data collected by the author from eight focus group discussions with thirty-two members of staff at a London hospice. The