Bioethics for clinicians: 18. Aboriginal cultures

ALTHOUGH PHILOSOPHIES AND PRACTICES ANALOGOUS TO BIOETHICS EXIST in Aborigi nal cultures, the terms and categorical distinctions of "ethics" and "bioet hics" do not generally exist. In this article we address ethical values app ropriate to Aboriginal patients, rather than a preconceived "Aboriginal bio ethic." Aboriginal beliefs are rooted in the context of oral history and cu lture. For Aboriginal people, decision-making is best understood as a proce ss and not as the correct interpretation of a unified code. Aboriginal cult ures differ from religious and cultural groups that draw on Scripture and t extual foundations for their ethical beliefs and practices. Aboriginal ethi cal values generally emphasize holism, pluralism, autonomy, community- or f amily-based decision-making, and the maintenance of quality of life rather than the exclusive pursuit of a cure. Most Aboriginal belief systems also e mphasize achieving balance and wellness within the domains of human life (m ental, physical, emotional and spiritual). Although these bioethical tenets are important to understand and apply, examining specific applications in detail is not as useful as developing a more generalized understanding of h ow to approach ethical decision-making with Aboriginal people. Aboriginal e thical decisions are often situational and highly dependent on the values o f the individual within the context of his or her family and community.