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A Case Study in Cross-cultural Health Care and Ethics

Who Decides What Is in the Child’s “Best Interest”?

Chrastek, Joan “Jody” Ramer, DNP; Goloff, Naomi, MD; Moore, Tisha, MDiv

Journal of Hospice & Palliative Nursing: February 2019 - Volume 21 - Issue 1 - p 8–13
doi: 10.1097/NJH.0000000000000529
Ethics Series

Health care in the United States is increasingly delivered in cross-cultural contexts. Empathy, mutual regard, respect, and compassionate communication are necessary to achieve the highest standard of care for each individual. Moral and ethical perspectives on life and death, health, and health care are not universal but rather have their origins within culture and societal norms. In a cross-cultural context, “the right decision” may be seen differently depending on an individual’s cultural background, discipline, and type of education. This pediatric case study is intended to stimulate conversation on the need for culturally sensitive health care decision making and the shortcomings of a “one-size-fits-all” approach to bioethics in our increasingly interconnected world.

Joan “Jody” Ramer Chrastek, DNP, is Pediatric Advanced Complex Care Team Coordinator, Fairview Home Care and Hospice, Minneapolis, Minnesota.

Naomi Goloff, MD, is Pediatric Advanced Complex Care Team Medical Director, Fairview Home Care and Hospice, Minneapolis, Minnesota.

Tisha Moore, MDiv, is Chaplain, University of Minnesota Masonic Children’s Hospital, Minneapolis.

The authors have no conflicts of interest to disclose.

Address correspondence to Joan “Jody” Ramer Chrastek, DNP, Fairview Home Care and Hospice, 2450 26th Ave South, Minneapolis, MN 55406 (

© 2019 by The Hospice and Palliative Nurses Association.