Wednesday, November 26, 2014

The medical profession requires cultural competencies.

This is from the NIH.

Culture is often described as (click here) the combination of a body of knowledge, a body of belief and a body of behavior. It involves a number of elements, including personal identification, language, thoughts, communications, actions, customs, beliefs, values, and institutions that are often specific to ethnic, racial, religious, geographic, or social groups. For the provider of health information or health care, these elements influence beliefs and belief systems surrounding health, healing, wellness, illness, disease, and delivery of health services. The concept of cultural competency has a positive effect on patient care delivery by enabling providers to deliver services that are respectful of and responsive to the health beliefs, practices and cultural and linguistic needs of diverse patients.

Teachers across the USA are finding cultural competence helpful in their classrooms.


To Help Educators Close Achievement Gaps (click here)

American classrooms are becoming increasingly diverse. As NEA President Dennis Van Roekel has noted, “Educators with the skills, knowledge, and attitudes to value the diversity among students will contribute to an educational system designed to serve all students well.” 
Cultural competence is a key factor in enabling educators to be effective with students from cultures other than their own....

Cultural competence in the USA is nearly always met with resistance. Yes, it is bias that plays the opposing power to having a country willing to understand each other.

I remember a curriculum that was to be introduced in Health Class by a school system (Sorry, I don't recall the city - I think it was in NJ - this was sometime ago).

The curriculum was called "The rainbow of culture in the USA" or something like that. The purpose was to introduce the fact the USA has many interests within all the cultures across the country. It was suppose to introduce tolerance of diversity. The topic the parents objected to was LGBT. They believed it would encourage experimentation and confusion with their children. I always though it was a lame excuse, but, the parents won the argument. The parents didn't necessarily reflect the wishes of all the parents in town, but, no different than any other oppressive element, the squeaky wheel gets the attention.

If the USA values diversity as a strength to its society there is no room for objection to learning about that diversity and embracing it. The question is how and when do these priorities reach into all areas of society?

The reason the topic came up today is because of the terrible relations between the people of Ferguson and it's police force. I'll tell you right now, Officer Wilson will carry out the education if it were required, but, it won't carry into his practice as a police officer. I'll tell you why.

This is going to sound racist, but, the content in which it is derived is racist. Police officers that are biased in their practice will voluntarily dismiss any requirements they don't have in their belief system. 

I believe Officer Wilson knew full well he was going to kill Michael Brown, Jr. I also believe Officer Wilson didn't care what black man he was going to murder. I think he knew it was going to escalate and he was going to kill this young man. Wilson pulled his gun while in the SUV. It fired twice and it served to scatter the two young men from where they were standing. And mind you they were actually walking before they were standing still. 

Wilson pulled his vehicle into their path in a way the young men were going to run into his vehicle. Is that someone who cares if he hits them with the vehicle? No. If he hit them with the vehicle and they were injured he would make up a story about how these two young black men and how he tried to swerve at their aggressive attempt to stop the SUV. It is what some officers do. They carry a bias with them that allows them to do their job. It reminds me of soldiers involved in war. In Vietnam it was "The Gooks." The depersonalize of the enemy allows a person to easily kill them as someone less than human. The Black community can strongly identify with the idea of being treated as less than human due to the history of the race in the USA.

When it comes to instilling acceptance of all people into the personality of human development as a natural way to thinking in the USA, it will be met with very deep resistance. The reason is because people have certain understandings of what freedom is about. The best example is the Gun Culture. They refuse to allow any public forum that controls this dangerous entity to be regulated or patrolled. An aspect of the Gun Culture won't even allow law makers to bring about any understanding other than complete anarchy of this PRODUCT. 

After Sandy Hook, there were many parent organizations that wanted as the minimum to owning or possessing (different capacities - not the same) a gun the requirement of a background check. At the time the polls were stating 60% to 70% of the USA wanted background checks for gun purchases.

The Gun Lobby that may or may not be a representative sample of parents were effecting elections and the measure never made it anywhere. That is the type of resistance that is meet with imposing/teaching cultural competencies. 

The medical profession demanding those competences of their licensed and unlicensed personnel meet with great success.  The reason? Because 'healing' is vital to medicine. The human condition is vital to medicine. Sometimes different races have differences in their medical path to healing. Often, medicine considers healing a physical, mental, emotional and spiritual event. So, the WHOLE PERSON has to be understood. Medicine knows for a fact there are races predisposed to alterations in health that are genetic. So, having cultural competency is vital to the practice.

Can we as a country achieve acceptance of diversity? Yes. In time. But, there are aspects of our diversity that currently will not budge because they believe they are superior OR they have the RIGHT to a choice in how they live and values they accept. 

Will police officers learn to understand diversity as part of their jobs? Sure, but, I'll you right now there will still be the kind of murders we are seeing now. Why? Because there is chronically the argument "I felt threatened." that wins in places of law.

That is why I strongly believe to resolve to an immediate solution there has to be representative samples of the populous being policed within the police department. In cities and towns as divided as Ferguson, Missouri has been even before Michael Brown, Jr.'s murder, REQUIRES a restructuring of the police force and the local government. This is about life and death. 

The practice of medicine is about life and death, but, also longevity. The police in their practice is only concerned about the law and enforcing it. To officers like Wilson it is a job and doing the job is black and white in it's application. No application in law is black and white. It is why law men or police officers hate judges and the courtroom. Law when written is not written to apply in a yes or no decision. One has to look to the courts to realize how law is applied to citizens lives. No decision by a judge is simple. The decision is about the individual, the life circumstances of the individual and how the crime occurred. 

Right? 

Let's say I get a speeding ticket and I was going 20 mph above the speed limit. It would be a serious issue in a courtroom. Endangering the public and breaking traffic control laws. But, what if such a ticket never was written and I was given a police escort to the hospital to insure safe and emergent arrival of my injured child? That is the law and how decisions are made in it's application. There are decisions by police on how to apply the law to individuals caught up in circumstances they can't handle without breaking the law.

In the case of the two young men in Ferguson, Officer Wilson decided long before he even turned down the street where the confrontation took place how he would treat them. He knew he was within his power WITH A GUN to carry out any solution to a problem if he was threatened by Big Black Men. That bias existed in him as a police officer long ago. So, when he nearly ran the two young men over the confrontation started. Make no doubt about it, Wilson escalated the circumstances causing Michael Brown Jr.'s death. It was not either of the young men that did it. What were his words according to the witness who was walking with Brown? "Get the f... on the sidewalk." 

"Get the f... on the sidewalk," is nothing but confrontational. Then to realize Wilson didn't pull the SUV he was driving over to the curb but actually put his face in the SUV in their face is nothing but confrontational. That was the practice of Officer Wilson. Tell me "Get the f... on the sidewalk," is effective communication that is going to garner cooperation. It isn't and Wilson was confrontation even before he realized the two young black men meet the description of the cigarillo thieves. Wilson stated he then realized the one man, namely Brown, was carrying to boxes of the stolen item. If he realized the stolen merchandise was in the hand of one of the men then he knew they were unarmed as well. 

The point is how does a society change the practitioners of public safety TODAY to prevent any more innocent deaths? It can't. It is not reasonable to have that happen. 

The reason Ferguson, Missouri had a better evening and night yesterday is because thousands of National Guard were available to keep the peace. That is how explosive these problems are in Ferguson. There are children involved here. There are community members that trained for police confrontation in order to carry out their protests. They weren't interested in having problems with police either. The circumstances are too volatile to expect this to simply go away. It isn't going  to happen. The only way this is going to stop is to bring new police officers into the department that can reflect the communities demographics and a few need to be from the community itself.


Cultural competency is an admirable goal, but, it won't work in places where people are sequestered into their own priorities. The priority of the citizens of Ferguson, Missouri is to stay alive and have their children stay alive. That isn't even prioritizing acceptance or inclusion; it prioritizes survival. When a community and a police department arrive at a priority of survival that is not a civil capacity where teaching diversity belongs. The circumstances are to inflexible and let's face it there are political problems within that community as well from the outside. As much as the American people want this to end there are political forces blaming the community in racist tones. There is danger even to the point whereby members of the KKK have stated their interest in being on the streets of Ferguson. There was also another 20 year old found dead. 

Cultural competency is fine. And it should go forward, but, that isn't going to stop the problems Ferguson and other cities now face. And Ferguson is only 21 thousand people.