Ethical principles and cultural integrity in health care delivery: Asian ethnocultural perspectives in genetic services

The tradition of Western thought is not always ubiquitous when working within the context of different ethnocultural populations, particularly that of Asian culture, and often poses ethical quandaries for health care professionals engaged in genetic services. For example, understanding the Asian ethnocultural perspective of patient autonomy, informed consent, and nondirective counseling from the Western perspective may be inappropriate and compromise cultural integrity and the delivery of effective genetic services because: (1) A distinction exists between the role of Asian (collective) autonomy vs. Western (individual) autonomy in the decision-making process. (2) The medical model is complementary to Asian expectations and respect of authority and may result in an uninformed consent to genetic professional's recommendations. (3) Misinterpretations of the normative decision-making process, misconceptions of normalcy, and the limits of tolerance of nondirective counseling may result in less effective treatment and compliance. Therefore, we suggest that acknowledging the impact of ethnicity and culture on ethical principles as applied in genetic services is essential in the assessment and delivery of ethically and culturally appropriate health care.