Fa'asāmoa bioethics and healthcare decision-making in New Zealand

Abstract

This paper addresses the shortcomings in the bioethics literature and the need to adequately address the lack of data on Pacific‐specific healthcare decision‐making in New Zealand. It provides evidence to address this gap in the bioethics literature whilst contributing to the discourse of decision‐making undertaken by Sāmoan Healthcare Professionals (HPs) (such as General Practitioners, Hospital Doctors and Nurses) as well as the separate healthcare decisions undertaken by Sāmoan medical patients. This research articulates the cultural tensions and limitations in dichotomizing cross‐cultural approaches to bioethics, whilst providing the plausible basis to develop a broad knowledge base of cultural factors, ethical practices, influences and understandings that are associated with fa'asāmoa bioethics in New Zealand. The interface between fa’asāmoa bioethics and health care decision making highlights the importance of capturing the social, spiritual, cultural and historical variables which fundamentally shape the beliefs of Sāmoan HPs as well as Sāmoan medical patients in New Zealand. These factors are not only complex but they also play an important role in the initiation, development and maintenance of fa'asāmoan bioethics in healthcare decisions. The task for the HP is to use his/her clinical skills to promote the patient’s wellbeing which requires that the patient’s own values and goals of care (Kaldijan 2004) are integrated in the healthcare decision‐making process (Brock 2009). Considerable attention will be directed to the field of bioethics whilst focusing on the clinical realities of HPs decision‐making (Siegler 1978). Given that New Zealand’s current system of healthcare decision‐making for HPs is guided by the New Zealand Medical Association Code of Ethics (also based on the Beauchamp and Childress (2013) four principles of biomedical ethics), in addition to the Code of Health and Disability Services Consumer’s Rights, it is arguably characterised as individualistic and self‐autonomous. Further research into fa’asāmoa bioethics may support the New Zealand HPs working with Sāmoan medical patients and alongside Sāmoan HPs through the development of a bioethical framework whilst enriching and adding value to the healthcare decision‐making discourse