Most healthcare providers work from ethical principles based on a Western model of practice that may not adhere to the cultural values intrinsic to Indigenous peoples. Breaking bad news is an important topic of ethical concern in health research. While much has been documented on BBN globally, the ethical implications of receiving bad news, from an Indigenous patient perspective in particular, is an area that requires further inquiry. This article discusses the experiences of Māori lung cancer patients and their families, (...) in order to investigate the ethical implications of receiving bad news. Data collection occurred through 23 semistructured interviews and nine focus groups with Māori lung cancer patients and their families in four districts in the Midland Region of New Zealand: Waikato, Bay of Plenty, Lakes and Tairāwhiti. The findings of this study were categorised into two key themes: communication and context. Avenues for best practice include understanding the centrality of the HCP–patient relationship and family ties in the healthcare journey, and providing patients with the full range of viable treatment options including hope, clear advice and guidance when the situation calls for it. Overall, the findings of this study hold implications for providing culturally safe and humanistic cancer care when BBN to Māori and Indigenous patients. (shrink)

Given the coterie of philosophers focused on everyday aesthetics, it's fascinating that gift reception has heretofore managed to escape their scrutiny. To enact a gift, recipients begin by imagining its use. On this level, gifts serve as a litmus test. In luring us, we're taken out of our normal ways of being to experience a different side of ourselves. Enacting a gift is thus a kind of performance, whose value depends on the donee’s interpretation, just as exhibitions, concerts, staged plays (...) or books are performances of visual art, scores, scripts or texts, whose interpretations demonstrate their aesthetic value. To develop the relationship between enacting gifts and performing artworks, I begin by surveying junctures along the gift-event’s arc: reply, imagination, trust, recognition, transformation and memory. Transformations arising from agonistic gifts strike me as significant because they characterise the way gifts challenge our beliefs, eventually altering our values. That we grow to love gifts, which we originally rejected out of hand, casts doubt on self-knowledge. Enacted gifts handily challenge self-knowledge’s twin features: authority and transparency. As this paper indicates, gift reception helps both to understand ourselves better and to remove the obstacles to what Quassim Cassim calls Substantive Self-Knowledge. (shrink)