Why Cultural Humility Requires Metaphysical Competency: The Dialectics of Clothing and Unclothing in the Hospital
Friday, October 13, 2023
8:00 AM – 9:15 AM ET
Location: Falkland (Fourth Floor)
Cultural competency has been a long-standing qualification of clinical ethicists for the American Society of Bioethics and Humanities (ASBH). In the face of significant criticism coming from anthropologists and critical theorists, cultural humility has been proposed as an alternative model. This paper will perform an immanent critique of cultural humility by demonstrating how its opposition to competency has introduced a dialectic between activity and passivity. But the juxtaposition between competent clinician, who actively imposes cultural stereotypes upon patients, and the humble clinician, who passively receives the particular enculturation of the patient, is far too simple. Indeed, this juxtaposition has obscured how the activity of becoming passive before the patient can harmfully deculture the clinician when cultural humility is one-sidedly focused on the patient. This deculturation is only a more subtle form of the current grammar of the hospital that requires all its participants (both patients and clinicians) to remove the marks of their culture and wear a uniform before entering the clinical space. In this paper, I will first argue that unless the clinical ethicist attends to both the culture of the patient and the clinician, they will inevitably obscure the cultural dynamics at work in mediation and potentially harm the clinician. Then, I will argue that, while we cannot abandon cultural humility, clinical ethicists must develop the metaphysical competency of discerning how cultural activity and passivity are at work in mediation to perform the task of ethics: discerning how particular agents can cooperatively seek their common good.