Reviews
Michael Brannigan has brought to this challengingly thoughtful book the ardor of his vocation as what he terms a philosopher by passion; his insightful powers of analysis; the richness of his continuous contact, as a participant observer, with health professional caregivers, patients, and their families; his multi-cultural knowledge and personal background; his talent as a teacher; and his admirable clarity as a writer. As its title indicates, this is a book about the nature of cultural competency, its vital significance in healthcare, and the social and cultural barriers to achieving it that exist both in the process of American medical education, and in the American system of health care delivery. But in addition, the book has a meta-message about what Brannigan regards as the existential essence of cultural competence. It is what he thinks of as the virtue of presence -of transcending Self as well as one's own culture sufficiently to be deeply present with the Other. For Brannigan, this kind of presence, which is epitomized in how health professionals ought ideally relate to, and communicate with patients and their families, is not confined to the sphere of medical encounters. Rather, it is a basic, ennobling constituent of our humanity. Brannigan effectively conveys this message without excessive sanctimony, and with due respect for the importance of integrating presence with relevant knowledge, trained skill, and experience-based wisdom., This is a book about the nature of 'cultural competency,' its vital significance in healthcare, and the social and cultural barriers to achieving it that exist both in the process of American medical education and in the American system of health care delivery. It has a meta-message about what Brannigan regards as 'the virtue of presence' -how health professionals ideally should relate to, and communicate with patients and their families., This is a book about the nature of 'cultural competency,' its vital significance in healthcare, and the social and cultural barriers to achieving it that exist both in the process of American medical education and in the American system of health care delivery. It has a meta-message about what Brannigan regards as 'the virtue of presence' --how health professionals ideally should relate to, and communicate with patients and their families., This book provides an opportunity for students and health care practitioners to reflect upon the philosophical meaning of "cultural competency." Using examples/scenarios from different cultures, Brannigan (College of Saint Rose) offers insights as a bioethicist on how to unveil the essence of cultural competency through the cultivation of presence. This intriguing work is important because American society consists of at least 66 diverse racial and ethnic groups with multiple values and worldviews. When members of diverse groups access the Western biomedical health care system, multiple clashes and conflicts can occur. To bridge these differences in cross-cultural communication, Brannigan offers insight from his work with multicultural patients and their families and caregivers. Chapter 1 discusses the challenges of colliding worldviews in pluralistic American society and health care. Chapter 2 defines cultural competency, and three critical values to understand culture: space, time, and modes of communication. In the final three chapters, Brannigan advocates for the cultivation of a "face-to-face engagement or being-with the patient" as an approach to improve patient-provider interactions. Strategies to cultivate presence in health care interactions may include active listening, pace, and reciprocity. A valuable resource for students and health care practitioners interested in the subject of cultural competency. Summing Up: Highly recommended.
