[From Self-Reflection to Building a "Culturally Safe" Care System].

Abstract

As Taiwanese society grows increasingly diverse and inclusive, the challenges faced in frontline clinical care are expanding beyond treating physical illnesses to include how to effectively embrace the life narratives and health beliefs of diverse populations. Although the long-standing emphasis on "cultural sensitivity" and "cultural competence" in the medical profession has encouraged healthcare professionals to learn about the customs and taboos of different cultures, research findings remind us that culture is not a fixed label. Lacking critical reflection on power imbalances, the accumulation of such knowledge may lead to the emergence and entrenchment of other forms of stereotyping (Curtis et al., 2019). The theme of this issue, "Cultural Safety in Nursing Practice", sincerely invites readers to reflect on whether our current standardized healthcare processes have unintentionally silenced certain voices. The articles featured in this issue provide accessible yet in-depth analyses of the multiple dimensions of cultural safety. At the theoretical level, we see how cultural safety resonates with emancipatory theory, cautioning against medical hegemony and advocating for returning to patients the authority to define their quality of care. In terms of practical application and implementation, cultural safety requires nurses to engage in critical self-reflection, active listening, and shared decision-making, thereby reconstructing a more equitable power relationship between healthcare providers and patients. Meanwhile, educational systems should strengthen the cultural teaching competencies of educators in the realms of foundational knowledge, facilitation skills, and curriculum design to foster more-inclusive learning environments. Ultimately, cultural safety must extend beyond the individual level into the organizational and policy levels as well. In one of the articles, the Indigenous Peoples Health Act (2023) is used to illustrate how respect for culture may be incorporated into healthcare indicators and administrative processes, suggesting a foundation for building a people-centered healthcare system that promotes health equity and social justice. Establishing a culturally safe care environment is a transformative process for healthcare professionals in diverse societies. However, cultural safety is not a one-time technical achievement. Thus, nursing practice must shift from merely "understanding cultural differences" to "examining the safety of care" by prioritizing the subjective experiences of care recipients and reconstructing power relations between providers and patients (Kaphle et al., 2022). Through the practical strategies introduced in this issue, we hope to inspire self-reflection and encourage all readers to become agents of change. Ultimately, every individual entering the healthcare system should feel seen and heard, and be able to receive care that is respectful of their cultural context within an environment of dignity.