REPLY 1 It’s important for nurses to provide culturally competent care. It’s important to assess the importance of a client’s culture/ethnicity (and their accompanying beliefs and values) when planning, providing, and evaluating care. Nurses' practice must incorporate cultural needs and beliefs into their nursing practice to provide care that is individualized for the client and appropriate to the client's needs (Cultural Awareness and Influences on Health: NCLEX-RN, 2020). In the Asian culture, there is often a belief that terminally ill patients should not be informed about their prognosis, and many believe that speaking of it may bring bad luck or a poor outcome (Ritter & Graham, 2017, P. 235). Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient’s knowledge or consent is ethically unacceptable (AMA, 2020). After completing a cultural assessment, if the patient holds this belief, I would respect the cultural practice and withhold the information.  The patient would be encouraged to specify preferences regarding the communication of medical information, preferably before the information becomes available (AMA, 2020); it’s important to honor a patient’s request not to receive certain medical information or to convey the information to a designated surrogate, provided these requests appear to represent the patient’s genuine wishes (AMA, 2020). For the family who believes this, “decisions and communication are often considered the responsibility of the oldest male in the family, and can be seen as a moral obligation for that person to act in that capacity” (Ritter & Graham, 2017, P. 235).  For health care providers to balance the patient’s right to know with respect to the cultural practices and beliefs of the family, it’s important to: assess the amount of information the patient is capable of receiving at a given time, and tailor disclosure to meet the patient’s needs and expectations in keeping with the individual’s preferences; Monitor the patient carefully and offer full disclosure when the patient is able to decide whether to receive the information (AMA, 2020).  In short, each year, the United States becomes more diverse, with people of different races and religions, and with differing beliefs about medicine and medical care. As nurses, we owe it to our patients to provide them with the best care possible in ways they find appropriate (Reed, 2017). References AMA. (2020). Withholding Information from Patients. Retrieved from https://www.ama-assn.org/delivering-care/ethics/withholding-information-patients Cultural Awareness and Influences on Health: NCLEX-RN. (2020). Retrieved from https://www.registerednursing.org/nclex/cultural-awareness-influences-health/ Reed, C. (2017). Cultural Competence. Retrieved from https://journals.lww.com/ajnonline/Fulltext/2017/07000/Cultural_Competence.5.aspx Ritter, L.A., & Graham, D.H. (2017). Multicultural H.

1. REPLY 1
It’s important for nurses to provide culturally competent care.
It’s important to assess the importance of a client’s
culture/ethnicity (and their accompanying beliefs and values)
when planning, providing, and evaluating care. Nurses' practice
must incorporate cultural needs and beliefs into their nursing
practice to provide care that is individualized for the client and
appropriate to the client's needs (Cultural Awareness and
Influences on Health: NCLEX-RN, 2020).
In the Asian culture, there is often a belief that terminally ill
patients should not be informed about their prognosis, and many
believe that speaking of it may bring bad luck or a poor
outcome (Ritter & Graham, 2017, P. 235). Except in emergency
situations in which a patient is incapable of making an informed
decision, withholding information without the patient’s
knowledge or consent is ethically unacceptable (AMA, 2020).
After completing a cultural assessment, if the patient holds this
belief, I would respect the cultural practice and withhold the
information.
The patient would be encouraged to specify preferences
regarding the communication of medical information, preferably
before the information becomes available (AMA, 2020); it’s
important to honor a patient’s request not to receive certain
medical information or to convey the information to a
designated surrogate, provided these requests appear to
represent the patient’s genuine wishes (AMA, 2020). For the
family who believes this, “decisions and communication are
often considered the responsibility of the oldest male in the
family, and can be seen as a moral obligation for that person to
act in that capacity” (Ritter & Graham, 2017, P. 235).

2. For health care providers to balance the patient’s right to know
with respect to the cultural practices and beliefs of the family,
it’s important to: assess the amount of information the patient is
capable of receiving at a given time, and tailor disclosure to
meet the patient’s needs and expectations in keeping with the
individual’s preferences; Monitor the patient carefully and offer
full disclosure when the patient is able to decide whether to
receive the information (AMA, 2020).
In short, each year, the United States becomes more diverse,
with people of different races and religions, and with differing
beliefs about medicine and medical care. As nurses, we owe it
to our patients to provide them with the best care possible in
ways they find appropriate (Reed, 2017).
References
AMA. (2020). Withholding Information from Patients.
Retrieved from https://www.ama-assn.org/delivering-
care/ethics/withholding-information-patients
Cultural Awareness and Influences on Health: NCLEX-RN.
(2020). Retrieved from
https://www.registerednursing.org/nclex/cultural-awareness-
influences-health/
Reed, C. (2017). Cultural Competence. Retrieved from
https://journals.lww.com/ajnonline/Fulltext/2017/07000/Cultura
l_Competence.5.aspx
Ritter, L.A., & Graham, D.H. (2017). Multicultural Health (2nd
ed.). Burlington, MA: Jones and
Bartlett Learning. ISBN: 9781284021028

3. REPLY 2
Health is viewed as a cultural concept, and culture
determines how we perceive the world. Therefore, respect for
cultural practice in Asia is predetermined because culture helps
shape how both the patient and the healthcare provider perceive
illness and what they believe to be its cause (Fowler et al.,
2011). I will only respect the culture if I lack the knowledge
and skills of delivering bad news, the appropriate provision of
optimal care to a dying patient, and the compassion to ensure
that the patient retains his or her self-worth even at the time of
his or her death.
According to Rosenberg et al. (2017), negative information
should be briefly relayed to patients. The author recommends
that the information be rehearsed to communicate the bad news
concisely and how the healthcare team is committed to the
patient's support and treatment at the terminally ill stage. A
good example of a prognosis that should be delivered to the
patient, especially by word of mouth, is as follows: 'The tests
done on your collected samples have confirmed that your
condition arose from a malignant tumor (sad news). Therefore, I
have informed a radiotherapist and the oncologist to speak with
you about the condition and then advise you further. Once I
receive the recommendations from their examinations on you, I
will decide on what best treatment to give to you (doing
something about it). As things unfold, I will always be around
to discuss with you on how we will go on with the treatment.'
Maintaining a silent observation at this point will lead to the
patient's psychological condition's best results (Sarafis et al.,
2014). Therefore, I will respect the culture, but any information
that must reach the patient will always be delivered just as the
profession prescribes.
Healthcare providers can balance the patient's right to

4. know their prognosis concerning their cultural practices and
beliefs. To achieve such a balance, healthcare personnel should
always try hard to become culturally sensitive (Chaet, 2016).
Such sensitive care can be achieved through creating awareness,
avoiding assumptions, and learning about other cultures. In any
social issue, the first step is always to be aware. Any competent
healthcare provider must always be endowed with culturally
sensitive care. A good nurse or doctor will always strive to
become culturally sensitive personnel while letting others
understand their line of duty (Swihart & Martin, 2020).
Secondly, a good healthcare provider should always avoid
making assumptions because it is always important not to
assume matters that you are not familiar with. Making such
assumptions can cause a breakdown of trust and rapport
between the healthcare provider and the patient. Lastly, a good
doctor or nurse should always learn about other cultures.
Learning a patient's culture includes their medical history,
medications, and current symptoms. Learning different cultures
will involve immersing oneself in the culture of others.
In conclusion, it is always essential to have a truthful and
open communication between the patient and the medic. Such
open communication will enhance trust in the relationship and
respect for autonomy. On the other hand, not fully disclosing
information to the patient is an ethical breach because it brings
the clash between the physician's duty of promoting the
patient's health and the physician's respect for the patient's
autonomy.
References:
Chaet, D. H. (2016). AMA Code of Medical Ethics’ Opinions
Related to Discrimination and Disparities in Health Care. AMA
Journal of Ethics, 18(11), 1095-1097.
Fowler, F. J., Levin, C. A., & Sepucha, K. R. (2011). Informing

5. And Involving Patients To Improve The Quality Of Medical
Decisions. Health Affairs, 30(4), 699–706.
https://doi.org/10.1377/hlthaff.2011.0003
Rosenberg, A. R., Starks, H., Unguru, Y., Feudtner, C., &
Diekema, D. (2017). Truth Telling in the Setting of Cultural
Differences and Incurable Pediatric Illness. JAMA Pediatrics,
171(11), 1113–1119.
https://doi.org/10.1001/jamapediatrics.2017.2568
Sarafis, P., Tsounis, A., Malliarou, M., & Lahana, E. (2014).
Disclosing the Truth: A Dilemma between Instilling Hope and
Respecting Patient Autonomy in Everyday Clinical Practice.
Global Journal of Health Science, 6(2), 128.
https://doi.org/10.5539/gjhs.v6n1p128
Swihart, D. L., & Martin, R. L. (2020). Cultural Religious
Competence In Clinical Practice. In StatPearls. StatPearls
Publishing. http://www.ncbi.nlm.nih.gov/books/NBK493216/
All replies must be constructive and use literature where
possible.
Your assignment will be graded according to the grading rubric.