Abstract

Definition of the problem: In health care institutions caregivers from different cultures treat patients who themselves may come from different cultural backgrounds. The ethical impact of this issue is how in spite of these cultural differences mutual understanding can be achieved. Modern health care systems must react to this multicultural challenge explaining: what does universality of the medical task mean, what are the consequences of demographic change, how to deal with the multicultural work force of the modern health care facilities, and how one must differentiate between universal and variable elements of the health care delivery. The following questions are discussed: 1. Which aspects of medicine require consideration of the multicultural structures? 2. Which medical fields must especially integrate multicultural perspectives? 3. How the patient's cultural context can be taken into account.Arguments: These levels of the problem are illustrated by the through the case of a German University hospital which presents a difficult decision making process.Conclusion: Three requirements result from this: 1. to work out the differences of behaviour, 2. to define the differences of value systems of both parts, the patient and the caregiver, and 3. to agree on mutual goals and values