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Bioethics for clinicians: continuing the series.

Understanding and accommodating patients’ values is a key aspect of patient-centred care. Patients respond to illness and make health care decisions within a unique personal context shaped by culture, religion, temperament and experience. The values and beliefs that they bring to health care decision-making may be the product of long and deep reflection, or may be largely unexamined. Many people faced with a crisis draw comfort and guidance from long-held beliefs; others find those beliefs sorely tried. Some patients are distressed to manoeuvre through a health care system whose implied values do not closely mirror their own. Clinicians become involved in health care choices as facilitators of the patient’s decision-making process. As such, they need an awareness of how their own cultural and religious background may influence their view of the patient’s situation, as well as familiarity with religious and culturally based values different from their own. Although understanding and accommodating the unique cultural and religious views of patients — especially in relation to the ethical aspects of practice — is a critical determinant of quality of care, guidance for physicians on how to do so is not easy to locate in the medical literature.